A case of neurofibroma which was confused with ganglioneuroma.

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Ganglioneuroma is a benign tumor of the autonomic nervous system and only rarely, if at all, occurs in the spinal ganglia.When a neurofibroma involves the ganglion, it resembles a ganglioneuroma microscopically and is occasionally erroneously diagnosed.In this paper we present a case of such a misleading tumor. The patient was a 42-year-old man, who complained of dysesthesia and weakness of both lower limbs. After a physical and roentgenological examination, we diagnosed an extradural spinal cord tumor and performed an operation. The tumor was discovered in the left eighth thoracic nerve root. It was compressing the dura and spinal cord, and had not extended beyond the intervertevral foramen. It was resected with the nerve root.At first, the histopathological diagnosis was "ganglioneuroma". On a second examination, however, ganglion cells in the tumor were found to be not neoplastic but autochthonous. The corrected diagnosis was neurofibroma involving the spinal ganglion.In ganglioneuroma, ganglion cells are abundant, distributed diffusely throughout the tumor and often bi-or multi-nucleated. Degenerative changes such as pyknosis, cytoplasmic eosinophilia and ballooning degeneration are common in the neoplastic cells, whereas satellite cells are often absent in ganglioneuroma, lymphoid aggregates, which are prominent in ganglioneuroma, are notably lacking in neurofibroma.One must be careful not to confuse ganglioneuroma with neurofibroma which traps the pre-existing ganglion.
西日本整形・災害外科学会の論文

A case of neurofibroma which was confused with ganglioneuroma.

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