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Scoliosis: an unusual clinical presentation of paraspinal ganglioneuroma

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Abstract

Purpose

To comprehensively present the clinical characteristics and treatment strategies in patients with scoliosis secondary to ganglioneuroma (S-GN).

Methods

Six patients with S-GN treated surgically at a median age of 12 years were retrospectively reviewed and the median follow-up period was 6 years (4–14 years). The radiological features of GN and the associated scoliosis were evaluated. The surgical strategies and the corresponding outcomes were investigated.

Results

All patients had a delayed diagnosis age of GN than scoliosis (12 vs. 9 years). GN was located at the posterior mediastinum in four patients (66.7%) and at retroperitoneum in two, respectively. Tumor occupancies were frequently detected on the X-ray films for four patients (66.7%), being uniformly on the convexity of the main curve. All patients complained of rapid progressive deformities during the growth period. Five patients (83.3%) received total tumor resections, one accepted partial resection. Deformity correction was implemented for all patients with an average rate of 66.4% on the main curve. No recurrence of the GN was detected for all totally tumor-resected patients at the latest follow-up.

Conclusion

S-GN is often misdiagnosed clinically. Paravertebral mass neighboring the apex of scoliosis can be meticulously detected from the X-ray films. Total tumor resection should be aggressively performed if possible. The deformity correction could be satisfactorily obtained and the risk of recurrence of the GN was relatively low.

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References

  1. Yang Y, Ren M, Yuan Z et al (2016) Thoracolumbar paravertebral giant ganglioneuroma and scoliosis: a case report and literature review. World J Surg Oncol 14:65

    Article  Google Scholar 

  2. Sampson M, Mitchell R, Morely T (1991) Case report: painless thoracic scoliosis due to dumb-bell ganglioneuroma—CT and MRI appearances. Clin Radiol 44:359–360

    Article  CAS  Google Scholar 

  3. Côté P, Cassidy JD, Dzus A et al (1994) Ganglioneuroma of the thoracic spine presenting as adolescent idiopathic scoliosis: a case report. J Spinal Disord 7:528–532

    PubMed  Google Scholar 

  4. Bauer B, Bauer H, Griss P et al (1989) Dumb-bell ganglioneuroma of the spine misinterpreted as progressive idiopathic scoliosis. Arch Orthop Trauma Surg 108:189–194

    Article  CAS  Google Scholar 

  5. Lai P-L, Lui T-N, Jung S-M et al (2005) Spinal ganglioneuroma mimicking adolescent idiopathic scoliosis. Pediatr Neurosurg 41:216–219

    Article  Google Scholar 

  6. Geoerger B, Hero B, Harms D et al (2001) Metabolic activity and clinical features of primary ganglioneuromas. Cancer 91:1905–1913

    Article  CAS  Google Scholar 

  7. Arab N, Alharbi A (2019) Retroperitoneal Ganglioneuroma (GN): case report in 14 years old boy. Int J Surg Case Reports 60:130–132

    Article  Google Scholar 

  8. Wang X, Yang L, Shi M et al (2018) Retroperitoneal ganglioneuroma combined with scoliosis: a case report and literature review. Medicine 97:e12328

    Article  Google Scholar 

  9. Ulusoy OL, Aribal S, Mutlu A et al (2016) Ganglioneuroma of the lumbar spine presenting with scoliosis in a 7-year-old child. Spine J 16:e727

    Article  Google Scholar 

  10. Qiu Y, Wang S, Wang B et al (2007) Adolescent thoracolumbar scoliosis secondary to ganglioneuroma: a two case report. Spine 32:E326–E329

    Article  Google Scholar 

  11. Spiegel DA, Helseth PH, Roback SA et al (2006) Atypical Scoliosis in a 14-year-old Girl. Clin Orthop Relat Res 1976–2007(447):270–276

    Article  Google Scholar 

  12. Paasch C, Harder A, Gatzky EJ et al (2016) Retroperitoneal paravertebral ganglioneuroma: a multidisciplinary approach facilitates less radical surgery. World J Surg Oncol 14:194

    Article  Google Scholar 

  13. Algazwi DAR, Elizabeth GL, Bhandari YR et al (2020) Pathological thoracic spine scoliosis due to ganglioneuroma. Am J Phys Med Rehabil 99:e13–e14

    Article  Google Scholar 

  14. Patrizia DE, Enrico P, Marta P et al (2014) Scoliosis secondary to ganglioneuroma: a case report and up to date literature review. J Pediatric Orthopaed 23:322–327

    Article  Google Scholar 

  15. Goldman RL, Winterling AN, Winterling CC (1965) Maturation of tumors of the sympathetic nervous system. Report of long-term survival in 2 patients, one with disseminated osseous metastases, and review of cases from the literature. Cancer 18:1510–1516

    Article  CAS  Google Scholar 

  16. Shephard R, Sutton D (1958) Dumb-bell ganglioneuromata of the spine with a report of four cases. Br J Surg 45:305–317

    Article  CAS  Google Scholar 

  17. Zhang Q, Li F, Liu D, et al (2020) A giant ganglioneuroma accompanied with scoliosis. Ann Roy College Surg Eng 102:e1–e3

  18. Elnady B, Abdelgawaad AS, Elkhayat H (2020) Giant intrathoracic ganglioneuroma with scoliosis treated by one-stage posterior resection and scoliosis correction: a case report. SICOT-J. https://doi.org/10.1051/sicotj/2020012

    Article  PubMed  PubMed Central  Google Scholar 

  19. Weaver AJ, Nakamoto K, Beals DA (2020) Secondary Scoliosis from a Retroperitoneal Ganglioneuroma in a 9-year-old female: case report. Marshall J Med 6:10

    Article  Google Scholar 

  20. Bao H, Yan P, Qiu Y et al (2016) Coronal imbalance in degenerative lumbar scoliosis: prevalence and influence on surgical decision-making for spinal osteotomy. Bone Jt J 98:1227–1233

    Article  Google Scholar 

  21. Du C-Z, Li S, Xu L et al (2019) Spinal Gorham-Stout syndrome: radiological changes and spinal deformities. Quant Imaging Med Surg 9:565

    Article  Google Scholar 

  22. Bulmer J (1966) Scoliosis complicating ganglion cell tumours. Br J Surg 53:619–624

    Article  Google Scholar 

  23. Osterhouse MD, Kettner NW, Birrer PT et al (2002) Ganglioneuroma masquerading as spinal pain. J Manipulative Physiol Ther 25:184–187

    Article  Google Scholar 

  24. Velyvis JH, Durbhakula S, Wurapa R et al (2005) Ganglioneuroma with scoliosis of the thoracic spine: a case report. Spine J 5:457–460

    Article  Google Scholar 

  25. Nachemson AL, Peterson L-E (1995) Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society. JBJS 77:815–822

    Article  CAS  Google Scholar 

  26. Demir MK, Yapıcıer Ö, Toktaş ZO et al (2015) Immature ganglioneuroma of the thoracic spine with lipomatous component: a rare cause of scoliosis. Spine J 15:e59–e61

    Article  Google Scholar 

  27. Kara T, Oztunali C (2013) Radiologic findings of thoracic scoliosis due to giant ganglioneuroma. Clin Imaging 37:767–768

    Article  Google Scholar 

  28. Rha SE, Byun JY, Jung SE et al (2003) Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 23:29–43

    Article  Google Scholar 

  29. Lonergan G, Schwab C, Suarez E et al (2002) Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma radiologic pathologic. Correlat Radiograph 22(2002):911–934

    Article  Google Scholar 

  30. Sánchez-Galán A, Barrena S, Vilanova-Sánchez A et al (2014) Ganglioneuroma: to operate or not to operate. Eur J Pediatr Surg 24:025–030

    Article  Google Scholar 

  31. Rigault P, Padovani J (1990) Ganglioneuroma and scoliosis. Report of 3 cases. Chirurgie 116:312–314

    CAS  PubMed  Google Scholar 

  32. Chen X, Ma Q, Wang S et al (2019) Surgical treatment of posterior mediastinal neurogenic tumors. J Surg Oncol 119:807–813

    Article  Google Scholar 

  33. Oue T, Yoneda A, Sasaki T et al (2008) Total laparoscopic excision of retroperitoneal ganglioneuroma using the hanging method and a vessel-sealing device. J Laparoendosc Adv Surg Tech 18:779–782

    Article  Google Scholar 

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Funding

This work was financially supported by the Jiangsu Provincial Key Medical Center (YXZXA2016009).

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Author notes

  1. Song Li and Saihu Mao contributed equally to this work.

Authors and Affiliations

  1. Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, Jiangsu Province, China

    Song Li, Saihu Mao, Yanyu Ma, Zezhang Zhu, Zhen Liu, Bangping Qian, Xu Sun & Yong Qiu

Authors
  1. Song Li
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  2. Saihu Mao
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  3. Yanyu Ma
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  4. Zezhang Zhu
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  6. Bangping Qian
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  7. Xu Sun
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  8. Yong Qiu
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Contributions

All authors: Made substantial contributions to the analysis, or interpretation of data. SL and all authors: the first draft of the manuscript was written by Song Li and all authors commented on previous versions of the manuscript. All authors: approved the version to be published All authors: agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Saihu Mao.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was by the local medical ethical review board by expedited review.

Informed consent

Informed consent was not required for this retrospective study on prerecorded deidentified radiographs.

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Li, S., Mao, S., Ma, Y. et al. Scoliosis: an unusual clinical presentation of paraspinal ganglioneuroma. Spine Deform 10, 1185–1195 (2022). https://doi.org/10.1007/s43390-022-00511-x

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  • DOI: https://doi.org/10.1007/s43390-022-00511-x

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