A Case of Ganglioneuroblastoma Presenting as Weakness of the Lower Extremities

Dong Hwan Yun; Kyung Tae Park; Byung-Kiu Park; Yun Jung Im; Eun Kyung Hong; Kang Sik Lee; Hyun Jung Kim; Hong Joon Kim

doi:10.5045/kjh.2007.42.4.414

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Yun, Park, Park, Im, Hong, Lee, Kim, and Kim: A Case of Ganglioneuroblastoma Presenting as Weakness of the Lower Extremities

Case Report

Korean J Hematol 2007;42(4):414-418.

Published online: 19 January 2007

DOI: https://doi.org/10.5045/kjh.2007.42.4.414

A Case of Ganglioneuroblastoma Presenting as Weakness of the Lower Extremities

Dong Hwan Yun, M.D., Kyung Tae Park, M.D.^1,, Byung-Kiu Park, M.D.², Yun Jung Im, M.D.³, Eun Kyung Hong, M.D.⁴, Kang Sik Lee, M.D.¹, Hyun Jung Kim, M.D.¹, Hong Joon Kim, M.D.¹

Department of Physical Medicine & Rehabilitation, Kyung Hee University College of Medicine, Seoul, Korea

¹Department of Rehabilitation Medicine, Eulji University School of Medicine, Seoul, Korea

²Pediatric Oncology Clinic, National Cancer Center, Seoul, Korea

³Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea

⁴Department of Pathology, National Cancer Center, Seoul, Korea

Correspondence to：Kyung Tae Park, M.D. Department of Rehabilitation Medicine, Eulji General Hospital, 280-1, Hagye-dong, Nowon-gu, Seoul 139-872, Korea Tel: ＋82-2-970-8315, Fax: ＋82-2-972-0068 E-mail: medianus@naver.com

Received 24 October 2007 Revised 15 November 2007 Accepted 20 November 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ganglioneuroblastoma is a rare tumor originating from the sympathetic chain. It is intermediate between the highly malignant neuroblastoma and the benign ganglioneuroma. The predilection sites of ganglioneuroblastoma are the retroperitoneum and mediastinum but involvement of the structures around the spinal cord is infrequent. A 4 year-old girl who had progressive weakness in both lower extremities had a tiptoe gait for 2 months. A magnetic resonance imaging (MRI) study revealed a heterogeneous enhancing mass in the right mediastinum and paraspinal areas. A biopsy of the mass confirmed a ganglioneuroblastoma with many neuroblasts and nodules of ganglion cells. This is an unusual case of a child with spastic paraplegia caused by ganglioneuroblastoma of the thoracic cavity.

Keywords: Ganglioneuroblastoma, Mediastinum, Spinal cord, Paraplegia

REFERENCES

1). Lopez-Ibor B., Schwartz AD. Neuroblastoma. Pediatr Clin North Am. 1985. 32:755–78.

2). Hamilton JP., Koop CE. Ganglioneuromas in children. Surg Gynecol Obstet. 1965. 121:803–12.

3). Ko HJ., Cha HJ., Choi KS., Sim BS. A case of dumb-bell shaped spinal ganglioneuroblastoma. J Korean Neurosurg Soc. 1975. 4:361–4.

4). Lee PM., Shin KD., Lee BC. A case of ganglioneuroblastoma. J Korean Pediatr Soc. 1977. 20:722–7.

5). Sibilla L., Martelli A., Farina L, et al. Ganglioneuroblastoma of the spinal cord. AJNR Am J Neuroradiol. 1995. 16(4 Suppl):875–7.

6). Ng TH., Fung CF., Goh W., Wong VC. Ganglioneuroma of the spinal cord. Surg Neurol. 1991. 35:147–51.

7). Gunlusoy B., Arslan M., Selek E., Sural S., Ayder AR. A case report: adrenal ganglioneuroblastoma in a 59-year old man. Int Urol Nephrol. 2004. 36:481–3.

8). Kubota M., Suita S., Yajiri T., Shono K., Fujii Y. Analysis of the prognostic factors relating to better clinical outcome in ganglioneuroblastoma. J Pediatr Surg. 2000. 35:92–5.

9). Sanal M., Meister B., Kreczy A., Unsinn K., Hager J. Intrathoracic ganglioneuroma and ganglioneuroblastoma: report of four cases. Eur Surg. 2005. 37:317–20.

10). Hsiao CC., Huang CC., Sheen JM, et al. Differential expression of delta-like gene and protein in neuroblastoma, ganglioneuroblastoma and ganglioneuroma. Mod Pathol. 2005. 18:656–62.

11). Stowens D. Neuroblastoma and related tumors. AMA Arch Pathol. 1957. 63:451–9.

12). Silverman L., Dahlin DC., Tyce GM., Stickler GB. Ganglioneuroblastoma: studies of pathologic changes and content of catecholamine. Am J Clin Pathol. 1964. 42:144–51.

13). Kedar A., Glassman M., Voorhess ML, et al. Severe hypertension in a child with neuroblastoma. Cancer. 1981. 47:2077–80.

14). Kim EK., Park JA., Park ES, et al. A case of op-soclonus-myoclonus-ataxia syndrome in ganglioneuroblastoma. Korean J Pediatr Hematol-Oncol. 2005. 12:114–9.

Fig. 1

T-shine MRI shows a huge paraspinal soft tissue mass with multiple neural foraminal encroachment and epidural involvement in C7 to T5 level (white arrows).

Fig. 2

Bone scan shows a soft tissue uptake in right paraspinal mass (black arrows).

Fig. 3

Undifferentiated neuroblasts (black arrows) and differentiated ganglion cells with abundunt cytoplasm (black arrowheads) are observed in light microscope findings of the tumor mass (H-E stain, ×400).

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