Ganglioneuroma

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Undertaken for cardiorespiratory reasons from primary care.

Patient Data

Age: 30 years
Gender: Male
x-ray

10x4cm smooth walled, well defined mass in the posterior mediastinum.  It extends to the apex of the thoracic cavity.  

No mediastinal shift.

Heart size normal.  Lungs clear.

ct

Well defined mass with small foci of calcification making an obtuse angle with the chest wall.   This lies in the posterior mediastinum extending from the apex to the level of T4.

Widening of the right T3 exit foramen.  No remodeling or destruction of the ribs or vertebra.

The lungs are clear.

No mediastinal lymphadenopathy.  Normal thyroid.

mri

Well defined isointense T1, variable T2 and heterogeneously enhancing mass in the left paravertebral space between T1 and T4, widening and extending from the left T2/T3 and T3/T4 neural foramen.

The central canal is normal in appearance.

Case Discussion

A very good example of a fellowship case starting with a plain film and further to cross sectional imaging.

Ganglioneuromas are benign tumors derived from neural crest cells and are most commonly identified in the posterior mediastinum as is in this case.

This was pathologically proven following surgical resection.

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