[Thoracic pain in an adolescent with a large intrathoracic mass]

Background: Ganglioneuromas are rare benign tumors of the sympathetic nervous system that predominantly occur in children and adolescents. They are most commonly located in the posterior mediastinum and often remain asymptomatic until they reach a considerable size. Case Presentation: We report the case of an adolescent who presented with intermittent right-sided chest pain. Chest radiography revealed a large intrathoracic mass, which was further characterized by computed tomography as a well-circumscribed right paravertebral lesion without radiological signs of malignancy. Ultrasound-guided transthoracic biopsy established the diagnosis of ganglioneuroma. Following multidisciplinary discussion, the patient underwent complete robot-assisted thoracoscopic resection. Histopathological examination confirmed a benign ganglioneuroma measuring 11.5 cm in maximum diameter. The postoperative course was uneventful, and the patient was discharged on the second postoperative day. At outpatient follow-up, the patient was asymptomatic and clinical as well as radiological examinations were unremarkable. Conclusion: Although rare, ganglioneuroma should be considered in the differential diagnosis of posterior mediastinal masses in adolescents presenting with persistent or recurrent chest pain and dyspnea. Cross-sectional imaging followed by histopathological confirmation is essential for diagnosis. Complete surgical resection is both diagnostic and curative, with an excellent prognosis.