RETROPERITONEAL APPROACH TO A RIGHT SYMPTOMATIC MATURE GANGLIONEUROMA chorange2404@gmail.com

PE097

RETROPERITONEAL APPROACH TO A RIGHT SYMPTOMATIC MATURE GANGLIONEUROMA

8

Greece

Poster Exhibition only

Ganglioneuromas are rare, benign tumors that originate from the sympathetic nervous system and are composed of mature ganglion cells, Schwann cells, and fibrous stroma. Mature ganglioneuromas are largely asymptomatic and discovered incidentally. Here, we present a case of a mature ganglioneuroma in a female adult patient treated by endoscopic retroperitoneal approach.

A 58-year-old individual presented to the outpatient clinic with complaints of intermittent abdominal discomfort that had persisted for several months. The pain was described as dull, non-radiating, and not associated with meals. MRI revealed a multi-lobular well-circumscribed, eterogenous, mass measuring 6.2 × 3.4 x 2.0 cm in the right retroperitoneal space, closely associated with the right adrenal gland but without evidence of invasion into adjacent structures. The mass extended between the inferior vena cava and the renal vessels. No calcifications, necrosis, or cystic changes were noted. MRI further characterized the mass as T1 hyperintense and T2 hypointense, with no contrast enhancement, suggestive of a benign etiology. Routine blood investigations, including complete blood count, liver and renal function tests, and inflammatory markers, were within normal limits. Endocrine testing was normal, including serum and urinary catecholamines and vanillylmandelic acid levels.

A right retroperitoneal adrenalectomy with excision of the adjacent tissues was performed. Post-operative course was uneventful. Histology showed mature ganglion cells embedded in a Schwannian stroma with areas of fibrous tissue. Immunohistochemistry was positive for S-100 protein and neuron-specific enolase (Stage L1 following INPC, Stage 1 in INSS

Mature ganglioneuromas have a benign potential and a retoperitoneoscopic approach is completely feasible.