Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2023; 15(5): 984-991
Published online May 27, 2023. doi: 10.4240/wjgs.v15.i5.984
Computer-assisted rescue of the inferior mesenteric artery in a child with a giant ganglioneuroblastoma: A case report
Wen-Li Xiu, Jie Liu, Jing-Li Zhang, Nan Su, Feng-Jiao Wang, Xi-Wei Hao, Fei-Fei Wang, Qian Dong
Wen-Li Xiu, Jing-Li Zhang, Nan Su, Xi-Wei Hao, Qian Dong, Department of Pediatric Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Wen-Li Xiu, Feng-Jiao Wang, Fei-Fei Wang, Qian Dong, Shandong Provincial Key Laboratory of Digital Medicine and Computer-assisted Surgery, Shandong College Collaborative Innovation Center of Digital Medicine Clinical Treatment and Nutrition Health, Qingdao University, Qingdao 266003, Shandong Province, China
Jie Liu, Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui Province, China
Author contributions: Xiu WL, Liu J, and Zhang JL contributed to data curation and writing of the original draft; Wang FJ and Wang FF contributed to data curation; Su N, Hao XW, and Dong Q contributed to manuscript review and editing; all authors have read and approved the final manuscript.
Supported by Qingdao Civic Science and Technology Program, No.17-3-3-8-nsh.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Qian Dong, MD, PhD, Chief Doctor, Professor, Surgeon, Department of Pediatric Surgery, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Shinan District, Qingdao 266000, Shandong Province, China.
Received: December 25, 2022
Peer-review started: December 25, 2022
First decision: January 10, 2023
Revised: January 22, 2023
Accepted: March 27, 2023
Article in press: March 27, 2023
Published online: May 27, 2023

Ganglioneuroblastoma (GNB) is a peripheral neuroblastoma (NB) with malignant degree between highly malignant NB and benign ganglioma (GN). Pathology is the gold standard of diagnosis. Although GNB is not uncommon in children, biopsy alone may lead to an inaccurate diagnosis, especially for giant tumors. However, surgical resection may be associated with significant complications. Here, we report a case of computer-assisted surgical resection of a giant GNB in a child and successful rescue of the inferior mesenteric artery.


A 4-year-old girl was admitted to our department for a giant retroperitoneal lesion, which was considered to be an NB by her local hospital. The symptoms of the girl disappeared spontaneously without treatment. On physical examination, a mass of about 10 cm × 7 cm could be palpated in her abdomen. Ultrasonography and contrast-enhanced computed tomography performed in our hospital also showed an NB, and there was a very thick blood vessel inside the tumor. However, aspiration biopsy revealed GN. Surgical resection is the best treatment option for this giant benign tumor. For precise preoperative evaluation, three-dimensional reconstruction was performed. It was clear that the tumor was close to the abdominal aorta. The superior mesenteric vein was pushed forward, and the inferior mesenteric artery passed through the tumor. Because GN generally does not invade blood vessels, we split the tumor with a CUSA knife during the operation and found that there was indeed a straight and intact vascular sheath. Arterial pulsation was observed in the completely exposed inferior mesenteric artery. The pathologists interpreting the tissue finally diagnosed it as a mixed GNB (GNBi), which is more malignant than GN. However, both GN and GNBi usually have a good prognosis.


This was a case of successful surgical resection of a giant GNB, and aspiration biopsy underestimated the pathological staging of the tumor. Preoperative three-dimensional reconstruction assisted with the radical resection of the tumor and rescue of the inferior mesenteric artery.

Keywords: Surgery, Children, Ganglioneuroblastoma, Computer-assisted, Tumor, Case report

Core Tip: The diagnosis and treatment of ganglioneuroblastoma is complex. Sampling errors associated with aspiration biopsy may lead to inaccurate diagnosis, while difficult surgical resection leads to many postoperative complications. Three-dimensional reconstruction and other technologies may contribute to the safety of surgery. Here, we introduce a child who underwent computer-assisted accurately guided surgical excision of a giant ganglioneuroblastoma, and her inferior mesenteric artery was rescued.