Paraspinal ganglioneuromas are extremely rare benign tumors.

Like neuroblastomas and ganglioneuroblastomas, ganglioneuromas are derived from the primordial neural crest cells that form the sympathetic nervous system.

Ganglioneuromas most commonly arise in the paravertebral sympathetic chains of the posterior mediastinum (41.5%) or retroperitoneum (37.5%). Less common sites include the adrenal gland (21%) and neck (8%). Paravertebral ganglioneuromas frequently extend through the neural foramina to involve the epidural space of the spinal canal.

The differential diagnosis for a posterior mediastinal mass is broad and includes:

  • neurogenic tumors
    • schwannoma
    • neurofibroma
    • malignant peripheral nerve sheath tumor
  • neuroblastic tumors
    • neuroblastoma
    • ganglioneuroma
  • non-neurogenic tumors
    • chordoma 
    • pheochromocytoma 
  • paraspinal abscess
  • descending aortic aneurysm
  • esophageal neoplasm
  • hernias 
    • hiatus hernia
    • Bochdalek hernia
  • lymphadenopathy or lymphoma 
  • extramedullary hematopoiesis
  • foregut duplication cysts
    • neurenteric cyst
    • esophageal duplication cyst
  • thoracic meningocoele