Clinical analysis on 18 cases of retroperitoneal ganglioneuroma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Weibin ¹ , CAO Kuan ² , ZHANG Bin ² , WEN Quan ² ,  WANG Renhao ²

1. Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221004, P. R. China;
2. Department of Hepatobiliary Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P. R. China;

Corresponding author：

WANG Renhao, Email: wangrenhaoxyfy@163.com

Keywords：

ganglioneuroma; retroperitoneal tumor; diagnosis; surgical therapy

DOI：

10.7507/1007-9424.201703126

Video：

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ObjectiveTo Summarize the clinical features of retroperitoneal ganglioneuroma.MethodsA total of 18 cases of pathologically confirmed retroperitoneal ganglioneuroma, who received surgery in The Affiliated Hospital of Xuzhou Medical University from May 2013 to July 2016, were collected to reviewe the clinical features, imaging findings, pathologic characteristics, treatments, and prognosis of retroperitoneal ganglioneuroma.Results① Clinical symptoms. Of the 18 cases, 8 cases were found by physical examination, and had no symptoms; 6 cases showed abdominal pain and discomfort; 3 cases had hypertension; 1 case had bulge and discomfort in the lower abdomen. ② Imaging performance. All of the 18 cases underwent color Doppler ultrasonography, 16 cases showed clear hypoechoic mass, and hypoechoic masses showed irregular shape in 2 cases; homogeneous echo in 12 cases and inhomogeneous echo in 6 cases could be seen. Seventeen cases underwent CT scan, and homogeneous low density in 14 cases, uneven density in 3 cases, scattered calcification in 3 cases could be seen. Fifteen cases underwent CT dynamic contrast-enhanced scan, 2 cases showed no significant enhancement both in dynamic and venous phase, 8 cases showed no significant enhancement in arterial phase, 11 cases showed heterogeneous enhancement in venous phase. Three cases underwent MRI scan, T1WI images of 3 cases showed uniform low signal; T2WI images showed high signal in 1 case, T2WI images showed high signal with moderate intensity in 2 cases. ③ Surgery and prognosis. Fifteen cases underwent laparoscopic retroperitoneal tumor resection,3 cases underwent open surgery, and all the tumors were completely resected. All cases had good postoperative recovery and no significant complication occurred. All cases were followed up for 6 to 32 months with a median of 20 months, no recurrence or distant metastasis was found during follow-up period.ConclusionsRetroperitoneal ganglioneuroma has nonspecific clinical manifestation. Imaging examinations are the most effective adjuvant ways preoperatively, but patholoy is still the gold standard of final diagnosis for ganglioneuroma. Radical tumor resection is the most effective therapy with satisfactory prognosis for ganglioneuroma.

Citation： YANG Weibin, CAO Kuan, ZHANG Bin, WEN Quan, WANG Renhao. Clinical analysis on 18 cases of retroperitoneal ganglioneuroma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(9): 1100-1105. doi: 10.7507/1007-9424.201703126 Copy

1.	吴青霞, 刘玉, 丁蓓, 等. 节细胞神经瘤的 CT 和 MRI 诊断. 放射学实践, 2010, 25(4): 414-416.
2.	连海英, 张雪林, 成官迅, 等. 节细胞神经瘤的 CT、MRI 诊断. 实用放射学杂志, 2006, 22(3): 281-284.
3.	董杰昌, 肖云翔, 蒋宁, 等. 肾上腺节细胞神经瘤的临床病理学分析. 中华泌尿外科杂志, 2006, 27(8): 520-522.
4.	Shimada H, Ambros IM, Dehner LP, et al. The International Neuroblastoma Pathology Classification (the Shimada system). Cancer, 1999, 86(2): 364-372.
5.	Lonergan GJ, Schwab CM, Suarez ES, et al. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics, 2002, 22(4): 911-934.
6.	李红文, 刘斌, 吴兴旺, 等. 节细胞神经瘤的 CT、MRI 诊断. 实用放射学杂志, 2013, 29(9): 1463-1466.
7.	Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
8.	Cai J, Zeng Y, Zheng H, et al. Retroperitoneal ganglioneuroma in children: CT and MRI features with histologic correlation. Eur J Radiol, 2010, 75(3): 315-320.
9.	Otal P, Mezghani S, Hassissene S, et al. Imaging of retroperitoneal ganglioneuroma. Eur Radiol, 2001, 11(6): 940-945.
10.	Williams PL, Bannister LH, Berry MM等著; 杨琳, 高英茂译. 格氏解剖学. 第 38 版. 沈阳: 辽宁教育出版社, 1999: 1299-1300.
11.	Yam B, Walczyk K, Mohanty SK, et al. Radiology-pathology conference: incidental posterior mediastinal ganglioneuroma. Clin Imaging, 2009, 33(5): 390-394.
12.	Camelo M, Aponte LF, Lugo-Vicente H. Dopamine-secreting adrenal ganglioneuroma in a child: beware of intraoperative rebound hypertension. J Pediatr Surg, 2012, 47(9): E29-E32.
13.	Polat AV, Polat AK, Aslan K, et al. Dopamine-secreting giant adrenal ganglioneuroma: clinical and diffusion-weighted magnetic resonance imaging findings. JBR-BTR, 2014, 97(2): 109-112.
14.	朱樱, 周建桥, 周密, 等. 肾上腺节细胞神经瘤彩色多普勒超声及超声造影表现. 中国超声医学杂志, 2012, 23(10): 951-953.
15.	Guo YK, Yang ZG, Li Y, et al. Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol, 2007, 62(3): 359-370.
16.	Majbar AM, Elmouhadi S, Elaloui M, et al. Imaging features of adrenal ganglioneuroma: a case report. BMC Res Notes, 2014, 7: 791.
17.	徐鹏, 徐凯. 肾上腺节细胞神经瘤 CT 表现: 4 例报告并文献复习. 中国介入影像与治疗学, 2011, 8(6): 483-485.
18.	Van Dyck P, Op de Beeck B, Parizel PM. Helical CT and dynamic MR features of an adrenal ganglioneuroma. JBR-BTR, 2006, 89(2): 77-79.
19.	周建军, 曾维新, 周康荣, 等. 肾上腺节细胞神经瘤的 CT 诊断价值. 中华放射学杂志. 2006, 40(10): 1021-1023.
20.	Radin R, David CL, Goldfarb H, et al. Adrenal and extra-adrenal retroperitoneal ganglioneuroma: imaging findings in 13 adults. Radiology, 1997, 202(3): 703-707.
21.	郭学军, 刘鹏程, 王成林, 等. 腹膜后节细胞神经瘤的影像学表现与病理分析. 中国医学影像技术, 2009, 25(8): 1443-1446.
22.	矫娜, 徐坚民, 龚静山, 等. 节细胞神经瘤的影像学表现与病理对照. 临床放射学杂志, 2014, 33(10): 1560-1563.
23.	张永华, 巴照贵, 赵绍宏, 等. 节细胞神经瘤的 MSCT 表现. 中国医学影像学杂志, 2010, 18(3): 248-251.
24.	黄东, 张岩, 韩鸿宾. 神经节细胞神经瘤的 MRI 与组织病理学对照研究. 中国医学影像技术, 2003, 19(11): 1548-1550.
25.	Zhang Y, Nishimura H, Kato S, et al. MRI of ganglioneuroma: histologic correlation study. J Comput Assist Tomogr, 2001, 25(4): 617-623.
26.	夏丹, 李奇孟, 汪朔, 等. 腹腔镜下腹膜后节细胞神经瘤切除术 30 例报告. 中华泌尿外科杂志, 2008, 29(3): 188-191.
27.	Iacobone M, Torresan F, Citton M, et al. Adrenal ganglioneuroma: The Padua Endocrine Surgery Unit experience. Int J Surg, 2017, 41 Suppl 1: S103-S108.

1. 吴青霞, 刘玉, 丁蓓, 等. 节细胞神经瘤的 CT 和 MRI 诊断. 放射学实践, 2010, 25(4): 414-416.
2. 连海英, 张雪林, 成官迅, 等. 节细胞神经瘤的 CT、MRI 诊断. 实用放射学杂志, 2006, 22(3): 281-284.
3. 董杰昌, 肖云翔, 蒋宁, 等. 肾上腺节细胞神经瘤的临床病理学分析. 中华泌尿外科杂志, 2006, 27(8): 520-522.
4. Shimada H, Ambros IM, Dehner LP, et al. The International Neuroblastoma Pathology Classification (the Shimada system). Cancer, 1999, 86(2): 364-372.
5. Lonergan GJ, Schwab CM, Suarez ES, et al. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics, 2002, 22(4): 911-934.
6. 李红文, 刘斌, 吴兴旺, 等. 节细胞神经瘤的 CT、MRI 诊断. 实用放射学杂志, 2013, 29(9): 1463-1466.
7. Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
8. Cai J, Zeng Y, Zheng H, et al. Retroperitoneal ganglioneuroma in children: CT and MRI features with histologic correlation. Eur J Radiol, 2010, 75(3): 315-320.
9. Otal P, Mezghani S, Hassissene S, et al. Imaging of retroperitoneal ganglioneuroma. Eur Radiol, 2001, 11(6): 940-945.
10. Williams PL, Bannister LH, Berry MM等著; 杨琳, 高英茂译. 格氏解剖学. 第 38 版. 沈阳: 辽宁教育出版社, 1999: 1299-1300.
11. Yam B, Walczyk K, Mohanty SK, et al. Radiology-pathology conference: incidental posterior mediastinal ganglioneuroma. Clin Imaging, 2009, 33(5): 390-394.
12. Camelo M, Aponte LF, Lugo-Vicente H. Dopamine-secreting adrenal ganglioneuroma in a child: beware of intraoperative rebound hypertension. J Pediatr Surg, 2012, 47(9): E29-E32.
13. Polat AV, Polat AK, Aslan K, et al. Dopamine-secreting giant adrenal ganglioneuroma: clinical and diffusion-weighted magnetic resonance imaging findings. JBR-BTR, 2014, 97(2): 109-112.
14. 朱樱, 周建桥, 周密, 等. 肾上腺节细胞神经瘤彩色多普勒超声及超声造影表现. 中国超声医学杂志, 2012, 23(10): 951-953.
15. Guo YK, Yang ZG, Li Y, et al. Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol, 2007, 62(3): 359-370.
16. Majbar AM, Elmouhadi S, Elaloui M, et al. Imaging features of adrenal ganglioneuroma: a case report. BMC Res Notes, 2014, 7: 791.
17. 徐鹏, 徐凯. 肾上腺节细胞神经瘤 CT 表现: 4 例报告并文献复习. 中国介入影像与治疗学, 2011, 8(6): 483-485.
18. Van Dyck P, Op de Beeck B, Parizel PM. Helical CT and dynamic MR features of an adrenal ganglioneuroma. JBR-BTR, 2006, 89(2): 77-79.
19. 周建军, 曾维新, 周康荣, 等. 肾上腺节细胞神经瘤的 CT 诊断价值. 中华放射学杂志. 2006, 40(10): 1021-1023.
20. Radin R, David CL, Goldfarb H, et al. Adrenal and extra-adrenal retroperitoneal ganglioneuroma: imaging findings in 13 adults. Radiology, 1997, 202(3): 703-707.
21. 郭学军, 刘鹏程, 王成林, 等. 腹膜后节细胞神经瘤的影像学表现与病理分析. 中国医学影像技术, 2009, 25(8): 1443-1446.
22. 矫娜, 徐坚民, 龚静山, 等. 节细胞神经瘤的影像学表现与病理对照. 临床放射学杂志, 2014, 33(10): 1560-1563.
23. 张永华, 巴照贵, 赵绍宏, 等. 节细胞神经瘤的 MSCT 表现. 中国医学影像学杂志, 2010, 18(3): 248-251.
24. 黄东, 张岩, 韩鸿宾. 神经节细胞神经瘤的 MRI 与组织病理学对照研究. 中国医学影像技术, 2003, 19(11): 1548-1550.
25. Zhang Y, Nishimura H, Kato S, et al. MRI of ganglioneuroma: histologic correlation study. J Comput Assist Tomogr, 2001, 25(4): 617-623.
26. 夏丹, 李奇孟, 汪朔, 等. 腹腔镜下腹膜后节细胞神经瘤切除术 30 例报告. 中华泌尿外科杂志, 2008, 29(3): 188-191.
27. Iacobone M, Torresan F, Citton M, et al. Adrenal ganglioneuroma: The Padua Endocrine Surgery Unit experience. Int J Surg, 2017, 41 Suppl 1: S103-S108.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical analysis on 18 cases of retroperitoneal ganglioneuroma

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