Ganglioneuroma is a rare neurogenic tumor which could grow into massive size in the thorax with minimal or no symptoms. Resection of these tumors will be challenging in view of large size and vascular encasement. Here, we report resection of a thoracic ganglioneuroma in a child with infiltration of spinal canal and lymph node metastasis, which is a very rare occurrence.
A 3-year and 10-month-old girl presented with a left side thoracic mass with minimal symptoms and signs. After the initial imaging with ultrasound scan and cross-sectional imaging, she had a true cut biopsy of the lesion confirming the diagnosis of ganglioneuroma. On exploration, she had a paraspinal thoracic mass extending from level of arch of aorta down to diaphragm with evidence of tumor infiltration of the intercostal spaces and spinal canal in multiple vertebral levels. Pathologically, she had infiltrated lymph nodes which were encircling the lower thoracic aorta. The tumor was resected successfully, and she recovered with a good functional status.
Thoracic ganglioneuroma has a good prognosis after complete resection even with spinal canal and lymph node infiltration. The resection could be arduous in case of massive size and vascular encasement; hence, benefit versus risk of complete resection should be carefully weighed.