[Retroperitoneal ganglioneuroma]

Ganglioneuroma is an infrequent tumor composed of sympathetic ganglion cells and sheathed neurites. It arises mainly from the large sympathetic chains, most frequently in the posterior mediastinum and retroperitoneum, but rarely may develop from the peripheral sympathetic chains. It is usually benign, and may grow asymptomatically to relatively large size. However, it can cause symptoms due to local expansion and pressure on adjacent structures. It does not seem to have hormonal activity. Some ganglioneuromas contain immature cells or elements of neuroblastoma or pheochromacytoma and can metastasize. The preoperative diagnosis of retroperitoneal tumors has now become more frequent due to the extensive use of imaging modalities, mainly computed axial tomography. Whenever the imaging correlates with the clinical presentation, or there is a reasonable suspicion of a malignancy, operation is indicated. Many retroperitoneal space-occupying lesions are found in asymptomatic patients during attempts to diagnose other diseases. In these cases opinions differ as to therapeutic approach. Many adrenal tumors may be benign adenomas, and several therapeutic protocols have been proposed. The clinician can decide on the basis of clinical presentation and radiographic features whether a conservative approach rather than operation is indicated. Since the majority of retroperitoneal tumors are malignant, histologic diagnosis is essential and in such cases surgical intervention is warranted. A young patient with a retroperitoneal ganglioneuroma is presented.