Headache as an unusual presenting symptom of retropharyngeal ganglioneuroma.
Ganglioneuromas are rare benign neurogenous neoplasms. The clinical symptoms of ganglioneuromas of the neck are usually mild and non-specific and definitive diagnosis requires a histological examination. We present the case of a 35-year-old female who complained of retroauricular pain as her first symptom and who was initially diagnosed with migraine. ENT examination revealed a bulging of the left pharyngeal wall. Fine-needle aspiration biopsy was misleading in terms of diagnosis. Histology after extirpation showed a ganglioneuroma. Ganglion cell differentiation was proven using the new intermediate filament class alpha-internexin immunohistochemical staining technique. Headache is an uncharacteristic symptom of ganglioneuroma and an interdisciplinary approach is required to find a possible cause. Periauricular pain without abnormal otoscopic findings should lead the otorhinolaryngologist to consider a retropharyngeal condition, especially if combined with dysphagia. Complete resection of the tumor using modern microsurgical techniques is the best way to extract ganglioneuroma today.
ENT Department, Friedrich-Schiller University, Jena, Germany. a.mueller@med.uni-jena.de
Andreas
A
Müller
Gerhard
G
Förster
Werner
W
Behrendt
Hartwig
H
Kosmehl
D000328:Adult; D005260:Female; D005729:Ganglioneuroma / Q000150:complications* / Q000601:surgery; D006261:Headache / Q000209:etiology*; D006801:Humans; D010610:Pharyngeal Neoplasms / Q000150:complications* / Q000601:surgery