Multiple Presacral Ganglioneuroma in an Adult Patient: Report on a Rare Case and a Literature Review

Abstract

Abstract

Background: Ganglioneuroma is a rare benign neoplasm originating from the sympathetic nerve chain. It can be located anywhere along the sympathetic nerve chain, but a presacral location is considered to be extremely uncommon. This article presents the rare case of multiple presacral ganglioneuromas in an adult patient. According to the available literature, regarding the location, this is the nineteenth case ever reported. As far as the number of tumors is concerned, it appears to be the first case ever reported. Case: A 31-year-old healthy female patient underwent a routine gynecologic examination by transvaginal ultrasound, which, incidentally, revealed a mass in the pelvis. The patient reported no back pain, weight loss, neurologic, or endocrinologic symptoms. Physical examination revealed a palpable pelvic mass, just in front of the sacrum, which was also confirmed by magnetic resonance imaging. The patient underwent laparotomy, and complete resection of three tumors was successfully performed. Results: The postoperative period was uneventful and the patient was discharged on the fifth postoperative day. Pathologic and immunohistochemical examination showed that all three tumors were ganglioneuromas without any evidence of malignancy. Conclusions: Multiple presacral ganglioneuromas are very rare, but they should be considered in differential diagnosis of a pelvic mass. Surgical excision sets the definite diagnosis and remains the treatment of choice. (J GYNECOL SURG 29:79)