Lumbar Ganglioneuroma from the Paravertebral Body Presenting in Continuity Between Intradural and Extradural Spaces

World Neurosurg. 2019 Aug:128:289-294. doi: 10.1016/j.wneu.2019.05.065. Epub 2019 May 15.

Abstract

Background: Ganglioneuroma is a well-differentiated benign tumor that develops from the ganglion cells of the posterior mediastinum, retroperitoneum, cervical spine, and adrenal glands. The paravertebral body, in which the sympathetic trunk exists, is a common tumor site, and tumor sometimes invades the spinal canal through the intervertebral foramen. There have been no reports regarding tumors with intradural and extradural continuity. We report a paravertebral ganglioneuroma extending between the intradural and extradural spaces and its surgical treatment.

Case description: A 33-year-old man was admitted to the hospital with progressive left lower limb numbness. A dumbbell-type tumor progressing to the spinal canal via the left intervertebral foramen from the paravertebral body at L1-2 was detected, and intradural calcified lesions were found. Pathologic examination of a computed tomography-guided biopsy sample revealed a ganglioglioma. The extradural tumor was removed; however, the left lower limb pain gradually worsened. As complete block was observed on myelography, the intradural tumor was removed 8 months later. Intraoperative findings revealed that the intradural and extradural tumors were continuous through the L1 nerve root.

Conclusions: This is the first known reported case of paravertebral ganglioneuroma presenting in continuity between the intradural and extradural spaces.

Keywords: Ganglioneuroma; Lumbar; Paravertebral body.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Calcinosis / diagnostic imaging
  • Calcinosis / surgery
  • Dura Mater / diagnostic imaging*
  • Ganglioneuroma / diagnostic imaging
  • Ganglioneuroma / surgery*
  • Humans
  • Image-Guided Biopsy
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / surgery*
  • Spinal Neoplasms / diagnostic imaging
  • Spinal Neoplasms / surgery*
  • Spinal Nerves / diagnostic imaging
  • Spinal Nerves / surgery
  • Tomography, X-Ray Computed