Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2019; 7(17): 2617-2622
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2617
Cause of postprandial vomiting - a giant retroperitoneal ganglioneuroma enclosing large blood vessels: A case report
Xue Zheng, Li Luo, Fu-Gang Han
Xue Zheng, Li Luo, Fu-Gang Han, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Zheng X consulted literature, collected images and wrote this paper. Luo L collected clinical data and consulted literature. Han FG designed the research, reviewed and revised the paper.
Informed consent statement: Informed written consent was obtained from the patient.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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:
Corresponding author: Fu-Gang Han, MD, Doctor, Full Professor, Deputy Director, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Third Section of Zhongshan Road, Jiangyang District, Luzhou 646000, Sichuan Province, China.
Telephone: +86-18308313971Fax: +86-0830-3636088
Received: April 2, 2019
Peer-review started: April 4, 2019
First decision: July 30, 2019
Revised: August 7, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: September 6, 2019

Ganglioneuroma (GN) is a rare neurogenic tumor that accounts for about 0.1%-0.5% of all tumors of the nervous system. It originates from neural crest cells. GN has no specific clinical symptoms or laboratory findings, which leaves it easily overlooked and misdiagnosed as other tumors. Retroperitoneal GN with very large volume and vascular penetration is extremely rare.


We present the imaging and pathological findings of a giant retroperitoneal GN in a child. A 4-year-old boy had suffered from postprandial vomiting for more than 6 mo with no precipitating factors. Abdominal computerized tomographic examination showed a giant cystic mass in the retroperitoneal area. After injection of contrast agent, the mass showed heterogeneous enhancement. Surgery with local excision of the mass was performed to address the embedded abdominal blood vessels, and the histopathological and immunohistochemical diagnosis of the mass was GN. Postprandial vomiting was relieved, and no complications occurred after the operation.


In the diagnosis of giant retroperitoneal hypodense masses in children, GN should be considered if the mass presents delayed enhancement, punctate calcification, and vascular embedding but no invasion. Pathology is the golden standard for the diagnosis of GN, and surgical excision is the optimal treatment for GN.

Keywords: Retroperitoneal, Ganglioneuroma, Postprandial vomiting, Case report

Core tip: Ganglioneuroma (GN) is a rare benign neurogenic tumor originating from the sympathetic nerve chain. Although it often occurs in the retroperitoneum, we report a case of giant GN causing postprandial vomiting and enclosing all major abdominal vessels, which is clinically rare. Surgical resection is the optimal choice for the treatment of GN at present. Pathology is the gold standard for the diagnosis of GN, and the presence of mucous matrix and ganglion cells are pathological features of GN.