Spinal ganglioneuroma presenting as a highly vascular lesion with hypertrophic venous drainage

We present the case of a 33-year-old man with a highly vascular spinal ganglioneuroma associated with hypertrophic draining veins mimicking arteriovenous malformation. Ganglioneuromas are classically known as avascular and association with hypertrohic venous drainage has not been previously reported. The magnetic resonance imaging and digital subtraction angiography features of this benign tumor were strongly suspicious for malignancy because of the high vascularity caused by intratumoral arteriovenous shunts. This case emphasizes the importance of including ganglioneuroma in the differential diagnosis of vascular spinal tumors and recalls that hypertrophic draining veins may be associated with spinal tumors.