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A Metastatic Neuroblastic Tumor in a 28-Month-old Boy: Unusual Spontaneous Regression From Neuroblastoma to Ganglioneuroma? J Pediatr Hematol Oncol 2022; 44:e589-e592. [PMID: 34054050 DOI: 10.1097/mph.0000000000002226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022]
Abstract
Neuroblastoma with bone metastasis is well known to have an extremely poor prognosis. We experienced the case of a patient with adrenal ganglioneuroblastoma (GNB) with metastases of subcutaneous nodules, a lymph node, and multiple bones. A pathologic examination of tumors from different sites revealed both GNB and ganglioneuroma. A genetic comparison between these tumors identified the same molecular signatures, suggesting the possibility of spontaneous differentiation in the remaining GNB. The patient has been healthy without aggressive chemotherapy, and the patient's pathologic urinary catecholamines normalized. Even if unusual, we have to recognize probable spontaneous differentiation from neuroblastoma to GNB and then to ganglioneuroma, even in sites of bone metastasis.
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Tas ML, Molenaar JJ, Peek AM, Lequin MH, Verdijk RM, de Krijger RR, Tytgat GA, van Noesel MM. Refractory Stage M Ganglioneuroblastoma With Bone Metastases and a Favorable, Chronic Course of Disease: Description of a Patient Cohort. J Pediatr Hematol Oncol 2022; 44:e5-e13. [PMID: 33885033 PMCID: PMC8728760 DOI: 10.1097/mph.0000000000002067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/13/2020] [Indexed: 11/26/2022]
Abstract
Refractory stage M neuroblastoma (NB) is associated with a poor prognosis and a progressive course of disease. Here, we describe a unique group of patients with a discrepant clinical course. Seven histologically confirmed ganglioneuroblastoma (GNB) (n=6) and differentiating NB (n=1) patients were identified who were diagnosed with stage M disease based on iodine-123-metaiodobenzylguanidine avid bone metastases. Six patients started on high-risk treatment, without tumor response (stable disease). Treatment was discontinued before the start of consolidation treatment because of refractory response in all patients. Unexpectedly, after cessation of treatment no progression of disease occurred. In 2 patients, the primary tumors expanded (>25%) very slowly during 1.5 and 3 years, and remained stable thereafter. Metabolically, a slow decrease of urinary homovanillic acid and vanillylmandelic acid levels and iodine-123-metaiodobenzylguanidine avidity was observed. All patients are alive with presence of metastatic disease after a median follow-up of 17 years (range: 6.7 to 27 y). Interestingly, at diagnosis, 6 patients were asymptomatic, 6 patients had GNB morphology, and 5 patients had meningeal metastases. These are all features seen in only a small minority of stage M patients. This GNB entity illustrates the clinical heterogeneity of neuroblastic tumors and can be used to further study the developmental origin of different NB subtypes.
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Affiliation(s)
| | | | - Annemarie M.L. Peek
- Departments of Solid Tumors
- Department of Pediatric Oncology, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen
| | - Maarten H. Lequin
- Departments of Solid Tumors
- Departments of Radiology and Nuclear Medicine
| | - Rob M. Verdijk
- Department of Pathology, Section Neuropathology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ronald R. de Krijger
- Diagnostics and Pathology, Princess Máxima Center for Pediatric Oncology
- Pathology, University Medical Center Utrecht, Utrecht
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Haitao S, Yao W, Xin J, Xiaopan C, Ting W, Yan L, Chenglong Z, Zhipeng W, Jianru X. Real-world experience with management of spinal ganglioneuroma: long-term follow-up observations of 31 cases. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:2896-2905. [PMID: 34146136 DOI: 10.1007/s00586-021-06896-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/12/2021] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Spinal ganglioneuroma (GN) is the most benign neoplasm of neuroblastic origin. There is little knowledge about spinal GN because of sporadic cases reported. The objective of this study is to describe the clinical manifestations and long-term follow-up outcomes of spinal GN after consecutive treatment. METHODS The clinical and follow-up data of 31 patients with spinal GN receiving consecutive treatment in our institute are retrospectively analyzed. RESULTS The mean age of the 31 patients was 40.39 ± 14.8 years. They were diagnosed with spinal GN and received surgical treatment in our institution between February 2012 and August 2019. Of them, 22 (71%) patients presented preoperative neurological symptoms. The mean duration from symptom onset to surgery was 19.76 ± 49.59 months. Eighteen patients received complete surgical resection and 13 patients received subtotal excision. In addition, radicotomy was performed simultaneously after sophisticated consideration in 19 patients. The follow-up period averaged 64.13 ± 22.67 months. The preoperative neurological dysfunction was improved significantly during the follow-up period in all cases. No local recurrence or malignant transformation has occurred so far. CONCLUSION Spinal GN is a rare but benign neoplasm, and the origin of spinal GN remains controversial. With our experience, we propose that the origin of spinal GN from dorsal root ganglion should be equally considered as its counterpart of sympathetic ganglion. Complete resection is the preferred surgical strategy to avoid malignant events and recurrence. And the close postoperative follow-up observations are warranted.
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Affiliation(s)
- Sun Haitao
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China
| | - Wang Yao
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China
| | - Jiang Xin
- Department of Anesthesiology, Changzheng Hospital, Shanghai, China
| | - Cai Xiaopan
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China
| | - Wang Ting
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China
| | - Lou Yan
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China
| | - Zhao Chenglong
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China.
| | - Wu Zhipeng
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China.
| | - Xiao Jianru
- Spine Tumor Center, Department of Orthopedic Oncology, Changzheng Hospital, No. 415 Fengyang Road, Huangpu District, Shanghai, China.
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Neuroblastic tumors in young adults as a sequela of malignant neuroblastoma: report of two cases. Abdom Radiol (NY) 2018; 43:1531-1534. [PMID: 29619527 DOI: 10.1007/s00261-018-1586-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma share the same histological spectrum which originates from neural crest cells. We present herein two young adult patients with neuroblastic tumors with lymph node metastases. Both the patients were diagnosed incidentally as having retroperitoneal masses, which showed little or no immature cells despite coexistence of lymph node involvement. The tumors were considered to represent spontaneous regression of malignant neuroblastoma. Radiologists should consider the possibility of spontaneous regression of neuroblastic tumors, when poorly enhanced multi-component masses at the retroperitoneum with lymph node involvement are visualized.
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Intradural Ganglioneuroma Mimicking Lumbar Disc Herniation: Case Report. World Neurosurg 2018; 117:40-45. [PMID: 29886296 DOI: 10.1016/j.wneu.2018.05.225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Ganglioneuroma (GN) is a slow-growing tumor originating from the neural crest-derived cells, which form the sympathetic nervous system. These tumors can affect anywhere along the peripheral autonomic ganglion sites and are most commonly found in the mediastinum and retroperitoneum. Spinal GNs are extremely rare and, so far, only 1 case arising from a lumbar nerve root has been reported in the English literature. GNs are often asymptomatic, and the majority of them are found incidentally in healthy subjects. Because of their slow growth, symptoms may result from the compressive effect of the tumor. CASE DESCRIPTION A 40-year-old man presented with a right sciatica episode accompanied by global muscle weakness and tingling pain. Findings of the neurologic examination displayed positive Lasegue test and sensory deficit over L5-S1 dermatomes. Magnetic resonance imaging of the lumbar spine without contrast showed a well-circumscribed longitudinal lesion arising from L5-S1 disc space, moving us toward a diagnosis of lumbar disc herniation. During surgery, we observed a mass well-encapsulated and oval-shaped inside S1 right root. The patient underwent subtotal resection. Histopathologic examination showed clusters of ganglion mature cells with neuromatous stroma, consistent with a ganglioneuroma. CONCLUSIONS We report a case that illustrates the clinical, radiologic, and histopathologic features of a ganglioneuroma mimicking a lumbosciatica syndrome and review related literature and similar cases.
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Hernandez Tejada F, Yedururi S, Kumar R, Stewart J, Tarek N. Ganglioneuroma with Disseminated Bone Lesions. Pediatr Blood Cancer 2017; 64. [PMID: 28221728 DOI: 10.1002/pbc.26298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 11/11/2022]
Affiliation(s)
| | - Sireesha Yedururi
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Texas, Houston
| | - Rajendra Kumar
- Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Texas, Houston
| | - John Stewart
- Department of Pathology, University of Texas MD Anderson Cancer Center, Texas, Houston
| | - Nidale Tarek
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Texas, Houston.,Department of Pediatrics and Adolescent Medicine, Children's Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
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Decarolis B, Simon T, Krug B, Leuschner I, Vokuhl C, Kaatsch P, von Schweinitz D, Klingebiel T, Mueller I, Schweigerer L, Berthold F, Hero B. Treatment and outcome of Ganglioneuroma and Ganglioneuroblastoma intermixed. BMC Cancer 2016; 16:542. [PMID: 27465021 PMCID: PMC4964292 DOI: 10.1186/s12885-016-2513-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 06/27/2016] [Indexed: 12/12/2022] Open
Abstract
Background Ganglioneuroma (GN) and ganglioneuroblastoma intermixed (GNBI) are mature variants of neuroblastic tumors (NT). It is still discussed whether incomplete resection of GN/GNBI impairs the outcome of patients. Methods Clinical characteristics and outcome of localized GN/GNBI were retrospectively compared to localized neuroblastoma (NB) and ganglioneuroblastoma-nodular (GNBN) registered in the German neuroblastoma trials between 2000 and 2010. Results Of 808 consecutive localized NT, 162 (20 %) were classified as GN and 55 (7 %) as GNBI. GN/GNBI patients presented more often with stage 1 disease (68 % vs. 37 %, p < 0.001), less frequently with adrenal tumors (31 % vs. 43 %, p = 0.001) and positive mIBG-uptake (34 % vs. 90 %, p < 0.001), and had less often elevated urine catecholamine metabolites (homovanillic acid 39 % vs. 62 %, p < 0.001, vanillylmandelic acid 27 % vs. 64 %, p < 0.001). Median age at diagnosis increased with grade of differentiation (NB/GNBN: 9; GNBI: 61; GN-maturing: 71; GN-mature: 125 months, p < 0.001). Complete tumor resection was achieved at diagnosis in 70 % of 162 GN and 67 % of 55 GNBI, and after 4 to 32 months of observation in 4 GN (2 %) and 5 GNBI (9 %). Eleven patients received chemotherapy without substantial effect. Fifty-five residual tumors (42 GN, 13 GNBI) are currently under observation (median: 44 months). Five patients (3 GN, 2 GNBI) showed local progression; all had tumor residuals > 2 cm. No progression occurred after subtotal resection. Two patients died of treatment, none of tumor progression. Conclusions GN/GNBI account for one quarter of localized NT and differ from immature tumors in their clinical features. Chemotherapy is not effective. Subtotal resection appears to be a sufficient treatment. Trial registration ClinicalTrials.gov identifiers - NB97 (NCT00017225; registered June 6, 2001); NB2004 (NCT00410631; registered December 11, 2006) Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2513-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Boris Decarolis
- Department of Pediatric Hematology and Oncology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Thorsten Simon
- Department of Pediatric Hematology and Oncology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Barbara Krug
- Department of Radiology, University of Cologne, Cologne, Germany
| | - Ivo Leuschner
- Department of Pathology, University of Kiel, Kiel, Germany
| | | | - Peter Kaatsch
- German Childhood Cancer Registry, University of Mainz, Mainz, Germany
| | - Dietrich von Schweinitz
- Department of Pediatric Surgery, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Thomas Klingebiel
- Clinic for Pediatric Hematology and Oncology, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Ingo Mueller
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg-Eppendorf, Germany
| | - Lothar Schweigerer
- Clinic for Pediatrics, Helios Klinikum Berlin-Buch, Berlin-Buch, Germany
| | - Frank Berthold
- Department of Pediatric Hematology and Oncology, Children's Hospital, University of Cologne, Cologne, Germany
| | - Barbara Hero
- Department of Pediatric Hematology and Oncology, Children's Hospital, University of Cologne, Cologne, Germany.
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Abstract
Recent genomic and biological studies of neuroblastoma have shed light on the dramatic heterogeneity in the clinical behaviour of this disease, which spans from spontaneous regression or differentiation in some patients, to relentless disease progression in others, despite intensive multimodality therapy. This evidence also suggests several possible mechanisms to explain the phenomena of spontaneous regression in neuroblastomas, including neurotrophin deprivation, humoral or cellular immunity, loss of telomerase activity and alterations in epigenetic regulation. A better understanding of the mechanisms of spontaneous regression might help to identify optimal therapeutic approaches for patients with these tumours. Currently, the most druggable mechanism is the delayed activation of developmentally programmed cell death regulated by the tropomyosin receptor kinase A pathway. Indeed, targeted therapy aimed at inhibiting neurotrophin receptors might be used in lieu of conventional chemotherapy or radiation in infants with biologically favourable tumours that require treatment. Alternative approaches consist of breaking immune tolerance to tumour antigens or activating neurotrophin receptor pathways to induce neuronal differentiation. These approaches are likely to be most effective against biologically favourable tumours, but they might also provide insights into treatment of biologically unfavourable tumours. We describe the different mechanisms of spontaneous neuroblastoma regression and the consequent therapeutic approaches.
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Affiliation(s)
- Garrett M Brodeur
- Division of Oncology, The Children's Hospital of Philadelphia, 3501 Civic Center Boulevard, Philadelphia, PA 19104-4302, USA
| | - Rochelle Bagatell
- Division of Oncology, The Children's Hospital of Philadelphia, 3501 Civic Center Boulevard, Philadelphia, PA 19104-4302, USA
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Son DW, Song GS, Kim YH, Lee SW. Ventrally located cervical dumbbell ganglioneuroma producing spinal cord compression. KOREAN JOURNAL OF SPINE 2013; 10:246-8. [PMID: 24891857 PMCID: PMC4040646 DOI: 10.14245/kjs.2013.10.4.246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 10/28/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022]
Abstract
Ganglioneuroma is an uncommon benign tumor and arise from neural crest cells or sympathetic and peripheral nerves. A 13-year-old boy was referred to our institute and presented with three-day history of right upper extremity weakness associated with neck pain for nearly one month. Magnetic resonance imaging showed right side dumbbell shaped extramedullary lesion at the C2-3 level extending outside through neural foramen. Paraspinal and posterior neck mass, cafe au lait spot was identified. We performed surgical decompression of the spinal cord by resection of intradural portion mass. Histopathological diagnosis was ganglioneuroma.
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Affiliation(s)
- Dong Wuk Son
- Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
| | - Geun Sung Song
- Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
| | - Young Ha Kim
- Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
| | - Sang Weon Lee
- Department of Neurosurgery, Pusan National University School of Medicine, Busan, Korea
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10
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Multiple persistent ganglioneuromas likely arising from the spontaneous maturation of metastatic neuroblastoma. J Pediatr Hematol Oncol 2012; 34:151-3. [PMID: 22052163 DOI: 10.1097/mph.0b013e318221ca82] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 10-year-old girl with multiple persistent ganglioneuromas originating from the spontaneous maturation of a metastatic neuroblastoma is described. Multiple biopsies confirm progressive maturation and urine catecholamines, which were initially elevated, have normalized over time. The management and risk of malignant transformation of ganglioneuromas is discussed.
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Qing Y, Bin X, Jian W, Li G, Linhui W, Bing L, Huiqing W, Yinghao S. Adrenal ganglioneuromas: a 10-year experience in a Chinese population. Surgery 2010; 147:854-60. [PMID: 20060552 DOI: 10.1016/j.surg.2009.11.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Accepted: 11/20/2009] [Indexed: 12/17/2022]
Abstract
BACKGROUND Adrenal ganglioneuroma (GN) is extremely rare. The present study is to describe the largest series of this adrenal tumor treated in a single medical center to our knowledge. METHODS Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively in 17 patients with incidentally discovered adrenal GN who received operative resection at a tertiary referral hospital in eastern China between June 1999 and June 2009. RESULTS The mean age of the 17 GN patients was 39.2 years (range, 7-72; male:female ratio, 1:2.4), of whom 13 patients had unilateral GN on the right side, and the remaining 4 on the left side. None of the 17 tumors was hormonally active. Only 6 of the 17 GN cases were diagnosed as benign nerve cell tumors by computed tomography or magnetic resonance imaging before operation. Treatment consisted of open unilateral adrenalectomy in 9 patients and laparoscopy in 8 patients. The mean pathologic size of the adrenal GNs was 6.3 +/- 3.1 cm (range, 1.0-13.0). Ultrastructural examination provided additional support for confirming the diagnosis. CONCLUSION Although there have been some clues for radiologic diagnosis of adrenal GN, pre-operative mis- and maldiagnosis are not infrequent. We recommend that complete operative resection should be considered once malignancy cannot be excluded by pre-operative evaluation. Laparoscopic adrenalectomy is a reasonable option at least for tumors < or =7 cm.
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Affiliation(s)
- Yang Qing
- Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China
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Jacob JT, Cohen-Gadol AA, Scheithauer BW, Krauss WE. Intramedullary spinal cord gangliocytoma: case report and a review of the literature. Neurosurg Rev 2005; 28:326-9. [PMID: 15739067 DOI: 10.1007/s10143-005-0383-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Accepted: 01/05/2005] [Indexed: 02/05/2023]
Abstract
We present a case of intramedullary spinal gangliocytoma in a 19-year-old woman who presented with a long history of hyperhidrosis of the face and neck areas and intermittent pain of the hands. The tumor involved the cervico-thoracic region of the spinal cord from C7-T3. The patient underwent debulking of the lesion and remains neurologically stable at two years follow-up. A discussion of this case is followed by a review of the literature surrounding this rare clinicopathological entity.
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Affiliation(s)
- Jeffrey T Jacob
- Department of Neurologic Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN, USA
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Ugarriza LF, Cabezudo JM, Ramirez JM, Lorenzana LM, Porras LF. Bilateral and symmetric C1-C2 dumbbell ganglioneuromas producing severe spinal cord compression. ACTA ACUST UNITED AC 2001; 55:228-31. [PMID: 11358598 DOI: 10.1016/s0090-3019(01)00363-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- L F Ugarriza
- Servicio de Neurocirugía. Hospital Universitario Infanta Cristina, Badajoz, Spain
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Trebo MM, Thorner PS, Bowman WP, Weitzman S. Long-term survival of a stage 4 neuroblastoma patient despite persistent bone marrow disease following autologous bone marrow transplantation. MEDICAL AND PEDIATRIC ONCOLOGY 1999; 33:585-7. [PMID: 10573586 DOI: 10.1002/(sici)1096-911x(199912)33:6<585::aid-mpo13>3.0.co;2-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M M Trebo
- Division of Hematology-Oncology, Department of Pediatrics, Hospital for Sick Children, Toronto, and University of Toronto, Toronto, Ontario, Canada
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15
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Bhattacharyya I, Williamson A, Cohen DM, Bever JL. Metastatic neuroblastoma with ganglioneuromatous differentiation and mandibular involvement. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1999; 88:586-92. [PMID: 10556754 DOI: 10.1016/s1079-2104(99)70090-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Neuroblastic tumors comprise neuroblastoma (NB), ganglioneuroblastoma, and ganglioneuroma (GN). NBs have shown remarkable differentiation capabilities, which include spontaneous regression. In the last 3 decades, the prognosis for metastatic NB has improved significantly. The ability to distinguish prognostic subtypes based on clinical and biologic features allows for understanding of this disease process and development of management procedures. NBs are often asymptomatic and remain undetected until a large abdominal mass or metastasis is found. GN, the most differentiated variant, is a benign neoplasm with significant growth potential and ability to cause clinical complications. GN of the mandible has seldom been reported in the literature in English. We present a case of NB metastatic to the mandible exhibiting ganglioneuromatous differentiation. We discuss the current understanding of the biology, grading, classification, and prognostic implications of NB.
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Affiliation(s)
- I Bhattacharyya
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE 68583, USA
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Mithöfer K, Grabowski EF, Rosenberg AE, Ryan DP, Mankin HJ. Symptomatic ganglioneuroma of bone. A case report. J Bone Joint Surg Am 1999; 81:1589-95. [PMID: 10565651 DOI: 10.2106/00004623-199911000-00011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- K Mithöfer
- Department of Orthopaedic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA
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Preidler KW, Ranner G, Szolar D, Walch C, Anderhuber W. Ultrasonography, CT and MRI of retropharyngeal ganglioneuroma: a very rare neoplasm in adults. Neuroradiology 1996; 38:378-80. [PMID: 8738101 DOI: 10.1007/bf00596594] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Ganglioneuroma, a rare benign tumour, very occasionally presents in adult life. We report a case with the additional unusual feature of a retropharyngeal location.
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Affiliation(s)
- K W Preidler
- Universitätsklinik für Radiologie, Graz, Austria
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19
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Affiliation(s)
- V Celik
- Department of General Surgery, Istanbul University Cerrahpşa Medical School, Turkey
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20
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Lucas K, Gula MJ, Knisely AS, Virgi MA, Wollman M, Blatt J. Catecholamine metabolites in ganglioneuroma. MEDICAL AND PEDIATRIC ONCOLOGY 1994; 22:240-3. [PMID: 8107654 DOI: 10.1002/mpo.2950220405] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
With rare exception, ganglioneuroma (GN) is a benign lesion which presents as a localized mass without metastatic potential and which is chemotherapy resistant. Thus, its distinction from neuroblastoma (NB) may be important. The diagnosis of GN implies the absence of neuroblastic elements. Incomplete resection prevents complete microscopic examination and raises the possibility that focal NB was not sampled. In an attempt to determine what features other than histology distinguish these two entities, we reviewed the charts of 25 patients with GN with regard to patient age and sex, tumor location and size, and urine catecholamine metabolite levels. One patient with GN (5%) and gross total resection had elevated quantitative vanillylmandelic acid (VMA) and homovanillic acid (HVA) levels (2.4 x upper limit of normal for age), and two others had positive spot analyses for VMA. An additional patient with a large mass, multiple biopsies of which documented GN, also had greatly elevated (approximately 5 x normal) VMA and HVA levels. However, a subsequent attempt at resection disclosed several gross foci of NB. Even excluding this patient, there was a trend for elevated values in GN patients to correlate with tumor size (P = .07 and .14 for VMA and HVA, respectively). The incidence of elevated values appears to increase as a function of tumor size, and small tumors are not likely to result in positive urinary measurements. We conclude that while elevations of VMA and HVA are consistent with a well-documented diagnosis of GN, extreme elevations (> 3 x nl) should prompt careful serial evaluation for occult NB.
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Affiliation(s)
- K Lucas
- Department of Pediatrics, Children's Hospital of Pittsburgh, Pennsylvania
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Abstract
A case of multiple ganglioneuroma arising along the entire length of the cervical sympathetic chain of one side of the neck is described. This is a distinctly unusual site and distribution of the disease and computed tomography proved invaluable to demonstrate its extent, in addition to excluding involvement of more caudal regions.
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Affiliation(s)
- J C Shotton
- Department of Otolaryngology, Kent Hospital, Tunbridge Wells
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22
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Ghali VS, Gold JE, Vincent RA, Cosgrove JM. Malignant peripheral nerve sheath tumor arising spontaneously from retroperitoneal ganglioneuroma: a case report, review of the literature, and immunohistochemical study. Hum Pathol 1992; 23:72-5. [PMID: 1544674 DOI: 10.1016/0046-8177(92)90015-u] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We report a case of a malignant peripheral nerve sheath tumor arising from a retroperitoneal ganglioneuroma in an adult male. There was no known previous history of a childhood neuroblastoma or of radiation therapy. In addition, the patient had no stigmata or family history of von Recklinghausen's neurofibromatosis. This case provides evidence that, although rare, spontaneous malignant transformation of ganglioneuroma can occur. Immunohistochemical studies supported that the spindle cell component was of nerve sheath origin.
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Affiliation(s)
- V S Ghali
- Department of Pathology, Beth Israel Medical Center, Mount Sinai School of Medicine, City University of New York, New York 10003
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23
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Abstract
Spontaneous maturation of Stage IVS neuroblastoma has been postulated as a mechanism for its favorable prognosis, but this has rarely been documented pathologically. We report on a patient with congenital Stage IVS neuroblastoma who had extensive subcutaneous and bone-marrow involvement. Serial photographs, biopsies, and vanillomandelic acid determinations documented the tumor's initial progression which was followed by spontaneous maturation and involution of the patient's disease over a 6-year period. No cytotoxic therapy was administered. Favorable biologic prognostic factors were documented, including tumor DNA and protein analyses for N-myc amplification or overexpression and analysis for serum neuron-specific enolase and ferritin. Implications for management and therapy of Stage IVS neuroblastoma are discussed with reference to this case and the recent literature.
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Affiliation(s)
- D Haas
- Department of Pediatrics, University of California, School of Medicine, San Francisco 94143
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24
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Chandrasoma P, Shibata D, Radin R, Brown LP, Koss M. Malignant peripheral nerve sheath tumor arising in an adrenal ganglioneuroma in an adult male homosexual. Cancer 1986; 57:2022-5. [PMID: 3955508 DOI: 10.1002/1097-0142(19860515)57:10<2022::aid-cncr2820571023>3.0.co;2-d] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The authors report a case of malignant peripheral nerve sheath tumor arising in an adrenal ganglioneuroma in an adult. This is the first such case occurring in the absence of a history of childhood neuroblastoma treated with radiation, and provides evidence that such a transformation can occur spontaneously. The neoplasm demonstrated a highly malignant biologic behavior with rapid growth, local recurrence, and metastasis.
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