This is a case of pathologically-proven ganglioneuroma. Pathological analysis demonstrates a schwannian stroma-predominant neuroblastic proliferation, composed of randomly-distributed microscopic foci of neuroblastic cells embedded in neuropils. The neuroblastic cells were predominantly differentiating neuroblasts including ganglion-like cells and, rarely, less differentiated neuroblasts. The mitosis-karyorrhexis index was low and no distinct nodules were identified. In immunohistochemical stains, S100 and SOX10 highlights schwannian stroma, a subset of neuroblasts are positive for neurofilament and chromogranin, and the neuropil is highlighted by synaptophysin. The findings are consistent with ganglioneuroblastoma, intermixed subtype.

The patient had an uneventful postoperative course and was discharged home on post-op day 1. Patient has been followed as an outpatient, noted to have a persistent left Horner’s syndrome.

Co-authors:
Alannah McCann
Travis Bevington, MD