title: Rhabdomyosarcoma arising from a dormant dumbbell ganglioneuroma of the lumbar spine: a case report.
abstract: METHODS
  A case report of a lumbar dumbbell tumor that showed a sequential change in histology from ganglioneuroma into rhabdomyosarcoma after long-term dormancy.
  
  
  OBJECTIVE
  To present a case of non-neurogenic malignancy arising from ganglioneuroma.
  
  
  BACKGROUND
  Ganglioneuromas rarely form the dumbbell variety. Whereas conversion of ganglioneuroma into neurogenic malignancies occurs occasionally, between ganglioneuroma and mesenchymal malignancies it has so far been limited to a case in which ganglioneuroma developed after chemo- and radiotherapy for orbital rhabdomyosarcoma.
  
  
  METHODS
  A 61-year-old man was referred with a recurrent retroperitoneal tumor that had been excised as ganglioneuroma. Using imaging, histologic, and immunohistochemical studies, a comparative analysis of the primary and recurrent tumors was performed.
  
  
  RESULTS
  A total of 44 histologic sections were examined for the primary and the recurrent tumors that had been excised surgically, with an 8-month interval between resections. Histologic and immunohistochemical findings in the primary tumor were consistent with ganglioneuroma, whereas those in the recurrent tumor indicated rhabdomyosarcoma.
  
  
  CONCLUSIONS
  It is assumed that the rhabdomyosarcoma arose from a dumbbell ganglioneuroma as a component of malignant ectomesenchymoma.
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawaguchi
authors.forename: Takuro
authors.initials: T
authors.lastname: Wada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagoya
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kikuchi
mesh_terms: D018450:Disease Progression; D017809:Fatal Outcome; D005729:Ganglioneuroma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012208:Rhabdomyosarcoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed