IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Retroperitoneal ganglioneuroma

Case contributed by Faeze Salahshour
Diagnosis certain

Presentation

Incidentally detected retroperitoneal lesion on US exam.

Patient Data

Age: 15 years
Gender: Female

A near fluid density lesion is seen in the midline and right side of the upper retroperitoneum close to the right adrenal gland. The lesion displaces IVC and pancreatic head anteriorly and insinuates between the aorta and IVC. Celiac trunk, and its common hepatic and proximal splenic artery seem to be encased as well as proximal SMA. Multiple foci of calcification are seen scattered in the lesion. Faint perceptible minimal enhancement is suggested on delayed images.

A low T2W and T1W retroperitoneal lesion with a minimal enhancing component is noted in the midline and right side of the upper retroperitoneum close to the right adrenal gland.

Case Discussion

Based on CT near-to-fluid density and minimal enhancement lymphangioma was suggested and MRI was performed for better evaluation, but the MR features, particularly the T2 signal, were not typical for lymphangioma

Lymphangioma, retroperitoneal low-grade mesenchymal tumors such as schwannoma and sarcoma were in the differential diagnosis, and the patient underwent core needle biopsy, which showed typical features of ganglioneuroma. Subsequently, the patient had the mass resected. 

Pathology report

GROSS DESCRIPTION: The specimen is received in a fresh state labeled as "retroperitoneal mass " consists of a piece of tan-reddish tissue measuring 15 x 8 x 3 cm. On cutting, reveals solid and cystic areas. Microscopic findings support the below diagnosis.

DIAGNOSIS: Retroperitoneal mass, resection specimen: Ganglioneuroma of the adrenal gland. The margins of resection are free from tumor.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.