Wang S, Ma JX, Zheng L, Sun ST, Xiang LB, Chen Y. Multiple bilateral and symmetric C1-2 ganglioneuromas: A case report. World J Clin Cases 2022; 10(31): 11549-11554 [PMID: 36387807 DOI: 10.12998/wjcc.v10.i31.11549]
Corresponding Author of This Article
Yu Chen, MD, Associate Chief Physician, Department of Orthopedics, General Hospital of Northern Theatre Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110000, Liaoning Province, China. spinechenyu@163.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Shuang Wang, Jun-Xiong Ma, Liang Zheng, Shao-Tong Sun, Liang-Bi Xiang, Yu Chen, Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang 110006, Liaoning Province, China
Author contributions: Wang S, Ma JX, Zheng L contributed equally to this work; Wang S, Chen Y designed the report; Ma JX, Zheng L, Sun ST collected the clinical data of the patient; Xiang LB and Chen Yu analyzed the data and wrote the paper.
Informed consent statement: The patient provided written informed consent for this case study.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu Chen, MD, Associate Chief Physician, Department of Orthopedics, General Hospital of Northern Theatre Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110000, Liaoning Province, China. spinechenyu@163.com
Received: June 22, 2022 Peer-review started: June 22, 2022 First decision: August 4, 2022 Revised: August 8, 2022 Accepted: October 9, 2022 Article in press: October 9, 2022 Published online: November 6, 2022
Abstract
BACKGROUND
Ganglioneuromas are rare tumors of the sympathetic nervous system that originate from neural crest sympathogonia. Since the cervical spine has rarely been reported as a site for ganglioneuroma, we present a case report on this uncommon manifestation.
CASE SUMMARY
A 34-year-old male presented with a 4-month history of progressive paralysis of both upper limbs along with an unsteady gait. The touch sensitivity of both hands was reduced, and there was conspicuously high muscle tonus in his upper and lower limbs, along with hyperactive physiological reflection and deep reflexes. Magnetic resonance imaging showed several nodules around the C2-7 intervertebral foramena, among which the masses lying between C1 and C2 were obviously bilaterally compressing the spinal cord. Successful posterior decompression was performed without fixation and the tumors in the upper cervical spine were removed intact, with rapid relief of symptoms. The pathological diagnosis was ganglioneuroma.
CONCLUSION
Multiple and bilateral ganglioneuroams are a rare occurrence in the cervical spine. In this case report, timely resection of the neoplasms around C1 and C2 resulted in spinal cord decompression, with rapid relief of symptoms and a good prognosis. Including the current case, we are aware of only seven such cases in the literature, of which four arose from Japan, one from China, and one from Spain. We suppose that ethnicity and geographic associations with this rare disease presentation may be an aspect for future consideration and investigation.
Core Tip: Ganglioneuromas is common benign tumor but uncommonly existing in the upper cervical spine. Meanwhile, this kind of tumor is rare to be multiple or bilateral. We present a 34-year-old male with the 4 mo history of paralysis in upper limbs and unsteady gait. The magnetic resonance imaging showed bilateral nodes from C2 to C7 intervertebral foramens, among which the bulks between C1 and C2 compressed the spinal cord obviously. The operation of posterior decompression was performed successfully without fixation and the tumors was removed integrally. The pathological diagnosis was ganglioneuromas. Including the current case, we are aware of only seven such cases in the literature, of which four arose from Japan, one from China, and one from Spain. We suppose that ethnicity and geographic associations with this rare disease presentation may be an aspect for future consideration and investigation.
