Clinical analysis on 18 cases of retroperitoneal ganglioneuroma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Weibin ¹ , CAO Kuan ² , ZHANG Bin ² , WEN Quan ² ,  WANG Renhao ²

1. Graduate School, Xuzhou Medical University, Xuzhou, Jiangsu 221004, P. R. China;
2. Department of Hepatobiliary Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221006, P. R. China;

Corresponding?author：

WANG Renhao, Email: wangrenhaoxyfy@163.com

Keywords：

ganglioneuroma; retroperitoneal tumor; diagnosis; surgical therapy

DOI：

10.7507/1007-9424.201703126

Video：

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ObjectiveTo Summarize the clinical features of retroperitoneal ganglioneuroma.MethodsA total of 18 cases of pathologically confirmed retroperitoneal ganglioneuroma, who received surgery in The Affiliated Hospital of Xuzhou Medical University from May 2013 to July 2016, were collected to reviewe the clinical features, imaging findings, pathologic characteristics, treatments, and prognosis of retroperitoneal ganglioneuroma.Results① Clinical symptoms. Of the 18 cases, 8 cases were found by physical examination, and had no symptoms; 6 cases showed abdominal pain and discomfort; 3 cases had hypertension; 1 case had bulge and discomfort in the lower abdomen. ② Imaging performance. All of the 18 cases underwent color Doppler ultrasonography, 16 cases showed clear hypoechoic mass, and hypoechoic masses showed irregular shape in 2 cases; homogeneous echo in 12 cases and inhomogeneous echo in 6 cases could be seen. Seventeen cases underwent CT scan, and homogeneous low density in 14 cases, uneven density in 3 cases, scattered calcification in 3 cases could be seen. Fifteen cases underwent CT dynamic contrast-enhanced scan, 2 cases showed no significant enhancement both in dynamic and venous phase, 8 cases showed no significant enhancement in arterial phase, 11 cases showed heterogeneous enhancement in venous phase. Three cases underwent MRI scan, T1WI images of 3 cases showed uniform low signal; T2WI images showed high signal in 1 case, T2WI images showed high signal with moderate intensity in 2 cases. ③ Surgery and prognosis. Fifteen cases underwent laparoscopic retroperitoneal tumor resection,3 cases underwent open surgery, and all the tumors were completely resected. All cases had good postoperative recovery and no significant complication occurred. All cases were followed up for 6 to 32 months with a median of 20 months, no recurrence or distant metastasis was found during follow-up period.ConclusionsRetroperitoneal ganglioneuroma has nonspecific clinical manifestation. Imaging examinations are the most effective adjuvant ways preoperatively, but patholoy is still the gold standard of final diagnosis for ganglioneuroma. Radical tumor resection is the most effective therapy with satisfactory prognosis for ganglioneuroma.

Citation： YANG Weibin, CAO Kuan, ZHANG Bin, WEN Quan, WANG Renhao. Clinical analysis on 18 cases of retroperitoneal ganglioneuroma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(9): 1100-1105. doi: 10.7507/1007-9424.201703126 Copy

1.	吳青霞, 劉玉, 丁蓓, 等. 節細胞神經瘤的 CT 和 MRI 診斷. 放射學實踐, 2010, 25(4): 414-416.
2.	連海英, 張雪林, 成官迅, 等. 節細胞神經瘤的 CT、MRI 診斷. 實用放射學雜志, 2006, 22(3): 281-284.
3.	董杰昌, 肖云翔, 蔣寧, 等. 腎上腺節細胞神經瘤的臨床病理學分析. 中華泌尿外科雜志, 2006, 27(8): 520-522.
4.	Shimada H, Ambros IM, Dehner LP, et al. The International Neuroblastoma Pathology Classification (the Shimada system). Cancer, 1999, 86(2): 364-372.
5.	Lonergan GJ, Schwab CM, Suarez ES, et al. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics, 2002, 22(4): 911-934.
6.	李紅文, 劉斌, 吳興旺, 等. 節細胞神經瘤的 CT、MRI 診斷. 實用放射學雜志, 2013, 29(9): 1463-1466.
7.	Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
8.	Cai J, Zeng Y, Zheng H, et al. Retroperitoneal ganglioneuroma in children: CT and MRI features with histologic correlation. Eur J Radiol, 2010, 75(3): 315-320.
9.	Otal P, Mezghani S, Hassissene S, et al. Imaging of retroperitoneal ganglioneuroma. Eur Radiol, 2001, 11(6): 940-945.
10.	Williams PL, Bannister LH, Berry MM等著; 楊琳, 高英茂譯. 格氏解剖學. 第 38 版. 沈陽: 遼寧教育出版社, 1999: 1299-1300.
11.	Yam B, Walczyk K, Mohanty SK, et al. Radiology-pathology conference: incidental posterior mediastinal ganglioneuroma. Clin Imaging, 2009, 33(5): 390-394.
12.	Camelo M, Aponte LF, Lugo-Vicente H. Dopamine-secreting adrenal ganglioneuroma in a child: beware of intraoperative rebound hypertension. J Pediatr Surg, 2012, 47(9): E29-E32.
13.	Polat AV, Polat AK, Aslan K, et al. Dopamine-secreting giant adrenal ganglioneuroma: clinical and diffusion-weighted magnetic resonance imaging findings. JBR-BTR, 2014, 97(2): 109-112.
14.	朱櫻, 周建橋, 周密, 等. 腎上腺節細胞神經瘤彩色多普勒超聲及超聲造影表現. 中國超聲醫學雜志, 2012, 23(10): 951-953.
15.	Guo YK, Yang ZG, Li Y, et al. Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol, 2007, 62(3): 359-370.
16.	Majbar AM, Elmouhadi S, Elaloui M, et al. Imaging features of adrenal ganglioneuroma: a case report. BMC Res Notes, 2014, 7: 791.
17.	徐鵬, 徐凱. 腎上腺節細胞神經瘤 CT 表現: 4 例報告并文獻復習. 中國介入影像與治療學, 2011, 8(6): 483-485.
18.	Van Dyck P, Op de Beeck B, Parizel PM. Helical CT and dynamic MR features of an adrenal ganglioneuroma. JBR-BTR, 2006, 89(2): 77-79.
19.	周建軍, 曾維新, 周康榮, 等. 腎上腺節細胞神經瘤的 CT 診斷價值. 中華放射學雜志. 2006, 40(10): 1021-1023.
20.	Radin R, David CL, Goldfarb H, et al. Adrenal and extra-adrenal retroperitoneal ganglioneuroma: imaging findings in 13 adults. Radiology, 1997, 202(3): 703-707.
21.	郭學軍, 劉鵬程, 王成林, 等. 腹膜后節細胞神經瘤的影像學表現與病理分析. 中國醫學影像技術, 2009, 25(8): 1443-1446.
22.	矯娜, 徐堅民, 龔靜山, 等. 節細胞神經瘤的影像學表現與病理對照. 臨床放射學雜志, 2014, 33(10): 1560-1563.
23.	張永華, 巴照貴, 趙紹宏, 等. 節細胞神經瘤的 MSCT 表現. 中國醫學影像學雜志, 2010, 18(3): 248-251.
24.	黃東, 張巖, 韓鴻賓. 神經節細胞神經瘤的 MRI 與組織病理學對照研究. 中國醫學影像技術, 2003, 19(11): 1548-1550.
25.	Zhang Y, Nishimura H, Kato S, et al. MRI of ganglioneuroma: histologic correlation study. J Comput Assist Tomogr, 2001, 25(4): 617-623.
26.	夏丹, 李奇孟, 汪朔, 等. 腹腔鏡下腹膜后節細胞神經瘤切除術 30 例報告. 中華泌尿外科雜志, 2008, 29(3): 188-191.
27.	Iacobone M, Torresan F, Citton M, et al. Adrenal ganglioneuroma: The Padua Endocrine Surgery Unit experience. Int J Surg, 2017, 41 Suppl 1: S103-S108.

1. 吳青霞, 劉玉, 丁蓓, 等. 節細胞神經瘤的 CT 和 MRI 診斷. 放射學實踐, 2010, 25(4): 414-416.
2. 連海英, 張雪林, 成官迅, 等. 節細胞神經瘤的 CT、MRI 診斷. 實用放射學雜志, 2006, 22(3): 281-284.
3. 董杰昌, 肖云翔, 蔣寧, 等. 腎上腺節細胞神經瘤的臨床病理學分析. 中華泌尿外科雜志, 2006, 27(8): 520-522.
4. Shimada H, Ambros IM, Dehner LP, et al. The International Neuroblastoma Pathology Classification (the Shimada system). Cancer, 1999, 86(2): 364-372.
5. Lonergan GJ, Schwab CM, Suarez ES, et al. Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics, 2002, 22(4): 911-934.
6. 李紅文, 劉斌, 吳興旺, 等. 節細胞神經瘤的 CT、MRI 診斷. 實用放射學雜志, 2013, 29(9): 1463-1466.
7. Rha SE, Byun JY, Jung SE, et al. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics, 2003, 23(1): 29-43.
8. Cai J, Zeng Y, Zheng H, et al. Retroperitoneal ganglioneuroma in children: CT and MRI features with histologic correlation. Eur J Radiol, 2010, 75(3): 315-320.
9. Otal P, Mezghani S, Hassissene S, et al. Imaging of retroperitoneal ganglioneuroma. Eur Radiol, 2001, 11(6): 940-945.
10. Williams PL, Bannister LH, Berry MM等著; 楊琳, 高英茂譯. 格氏解剖學. 第 38 版. 沈陽: 遼寧教育出版社, 1999: 1299-1300.
11. Yam B, Walczyk K, Mohanty SK, et al. Radiology-pathology conference: incidental posterior mediastinal ganglioneuroma. Clin Imaging, 2009, 33(5): 390-394.
12. Camelo M, Aponte LF, Lugo-Vicente H. Dopamine-secreting adrenal ganglioneuroma in a child: beware of intraoperative rebound hypertension. J Pediatr Surg, 2012, 47(9): E29-E32.
13. Polat AV, Polat AK, Aslan K, et al. Dopamine-secreting giant adrenal ganglioneuroma: clinical and diffusion-weighted magnetic resonance imaging findings. JBR-BTR, 2014, 97(2): 109-112.
14. 朱櫻, 周建橋, 周密, 等. 腎上腺節細胞神經瘤彩色多普勒超聲及超聲造影表現. 中國超聲醫學雜志, 2012, 23(10): 951-953.
15. Guo YK, Yang ZG, Li Y, et al. Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol, 2007, 62(3): 359-370.
16. Majbar AM, Elmouhadi S, Elaloui M, et al. Imaging features of adrenal ganglioneuroma: a case report. BMC Res Notes, 2014, 7: 791.
17. 徐鵬, 徐凱. 腎上腺節細胞神經瘤 CT 表現: 4 例報告并文獻復習. 中國介入影像與治療學, 2011, 8(6): 483-485.
18. Van Dyck P, Op de Beeck B, Parizel PM. Helical CT and dynamic MR features of an adrenal ganglioneuroma. JBR-BTR, 2006, 89(2): 77-79.
19. 周建軍, 曾維新, 周康榮, 等. 腎上腺節細胞神經瘤的 CT 診斷價值. 中華放射學雜志. 2006, 40(10): 1021-1023.
20. Radin R, David CL, Goldfarb H, et al. Adrenal and extra-adrenal retroperitoneal ganglioneuroma: imaging findings in 13 adults. Radiology, 1997, 202(3): 703-707.
21. 郭學軍, 劉鵬程, 王成林, 等. 腹膜后節細胞神經瘤的影像學表現與病理分析. 中國醫學影像技術, 2009, 25(8): 1443-1446.
22. 矯娜, 徐堅民, 龔靜山, 等. 節細胞神經瘤的影像學表現與病理對照. 臨床放射學雜志, 2014, 33(10): 1560-1563.
23. 張永華, 巴照貴, 趙紹宏, 等. 節細胞神經瘤的 MSCT 表現. 中國醫學影像學雜志, 2010, 18(3): 248-251.
24. 黃東, 張巖, 韓鴻賓. 神經節細胞神經瘤的 MRI 與組織病理學對照研究. 中國醫學影像技術, 2003, 19(11): 1548-1550.
25. Zhang Y, Nishimura H, Kato S, et al. MRI of ganglioneuroma: histologic correlation study. J Comput Assist Tomogr, 2001, 25(4): 617-623.
26. 夏丹, 李奇孟, 汪朔, 等. 腹腔鏡下腹膜后節細胞神經瘤切除術 30 例報告. 中華泌尿外科雜志, 2008, 29(3): 188-191.
27. Iacobone M, Torresan F, Citton M, et al. Adrenal ganglioneuroma: The Padua Endocrine Surgery Unit experience. Int J Surg, 2017, 41 Suppl 1: S103-S108.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical analysis on 18 cases of retroperitoneal ganglioneuroma

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