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Updated: Jul 15, 2025
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
Nonspecific Gastrointestinal Symptoms as the First Sign of Ganglioneuroblastoma Intermixed-Case Report and Literature
Łukasz Lipiński1, Justyna Lipińska1, Maria Kowalczuk1
1Students' Scientific Society at the Department of Pediatric Radiology, Medical University of Lublin, 20-093 Lublin, Poland.
Insights
Nonspecific gastrointestinal symptoms in children can mask rare neuroblastic tumors (NTs). Early diagnosis of ganglioneuroblastoma is crucial, as these tumors often present with advanced disease.
Area of Science:
- Pediatric Oncology
- Gastroenterology
Background:
- Nonspecific gastrointestinal symptoms are common in children, posing diagnostic challenges.
- Rarely, these symptoms can indicate serious underlying conditions like neoplastic processes.
Purpose of the Study:
- To review current information on ganglioneuroblastoma.
- To emphasize nonspecific gastrointestinal symptoms as an early sign of this tumor.
- To highlight diagnostic approaches for ganglioneuroblastoma.
Main Methods:
- Case presentation of a 5-year-old boy with prolonged diagnostic workup.
- Diagnostic imaging including X-ray and ultrasound.
- Surgical removal and histopathological examination of the tumor.
Main Results:
- A 5-year-old boy presented with severe abdominal pain and signs of intestinal obstruction.
- Ultrasound revealed a possible malignant lesion in the left adrenal gland.
- Histopathology confirmed the diagnosis of intermixed ganglioneuroblastoma, a type of neuroblastic tumor.
Conclusions:
- Neuroblastic tumors (NTs) are rare but common extracranial solid tumors in children.
- Delayed presentation is frequent, often with advanced neoplastic processes.
- Recognizing gastrointestinal symptoms as potential indicators of NTs is vital for timely diagnosis and treatment.
Abstract:
Nonspecific gastrointestinal symptoms remain a problem for pediatricians because, out of a thousand trivial cases, there are rare diseases that require in-depth diagnostics and extensive knowledge to identify them. These complaints may be caused by a neoplastic process. We present the case of a 5-year-old boy whose diagnostic pathway lasted about 3 months. He was admitted to hospital due to severe abdominal pain. Physical examination revealed a bloated, hard, and painful abdomen. In the standing X-ray, the features of intestinal obstruction were visualized. An ultrasound examination showed a possible malignant lesion in the location of the left adrenal gland. After the surgical removal of the pathological mass and histopathological examination, the diagnosis of ganglioneuroblastoma intermixed was made. This tumor, along with neuroblastoma, ganglioneuroma, and ganglioneuroblastoma nodular, belongs to neuroblastic tumors (NTs), which originate from primitive cells of the sympathetic nervous system. NTs are quite rare, but they are still the majority of extracranial solid tumors in children, and their symptoms often appear relatively late when the neoplastic process is already advanced. The purpose of this review is to present current information about ganglioneuroblastoma, with a special emphasis on nonspecific gastrointestinal symptoms as first sign of this tumor and its diagnostics.
