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Paravertebral Ganglioneuroma in Pediatric Age: A Case Report
Andreia Lasca1, Inês Laia1, Raquel Pires Santos1
1Family Medicine, Unidade de Saúde Familiar Viriato, Serviço Nacional de Saúde, Viseu, PRT.
Insights
This case highlights a rare pediatric ganglioneuroma (GN) presenting with neurological symptoms. Early detection during surveillance is crucial for timely diagnosis and successful treatment of these benign tumors.
Area of Science:
- Pediatric Neurology
- Oncology
- Rare Diseases
Background:
- Ganglioneuromas (GNs) are rare, benign tumors predominantly affecting the pediatric population.
- While often asymptomatic, GNs can manifest with neurological symptoms, necessitating thorough investigation.
Observation:
- A two-year-old male presented with gait abnormalities, hypotonia, and a positive Gowers sign during a routine surveillance appointment.
- Initial imaging suggested neuroblastoma, but a biopsy confirmed a paravertebral ganglioneuroma.
Findings:
- Surgical resection of the paravertebral ganglioneuroma was performed, with some residual tumor.
- The child achieved a normal neurological examination after one year of intensive motor rehabilitation.
Implications:
- This case underscores the importance of regular child health surveillance for early detection of rare pediatric conditions.
- It emphasizes that even rare tumors like ganglioneuromas can present with significant neurological findings, requiring a broad differential diagnosis.
Abstract:
Ganglioneuromas (GNs) are rare benign tumors common in the pediatric population. Although mostly asymptomatic, some can cause symptoms, particularly neurological ones. Here, we report a case of a two-year-old male child, who presented changes in gait, an alarming sign, during a child health surveillance appointment. On physical examination, the child presented a "duck" gait pattern, axial and appendicular hypotonia, proximal weakness of the pelvic girdle, and a positive Gowers sign. The child was referred to a pediatric neurology appointment where he underwent neuraxial magnetic resonance imaging, identifying a large and expansive formation in the dorsolumbar transition suggestive of neuroblastoma, considering the age group. However, a computed tomography-guided biopsy revealed it to be a paravertebral GN. Tumor resection was performed, leaving some paravertebral tumor residue. After one year of motor rehabilitation, the child had a normal neurological examination. The child is currently five years old and is undergoing annual clinical and imaging surveillance. This case allows us to reflect on the importance of encouraging children and young people to attend recommended surveillance appointments and reminds us that the rarest situations can occur.
