title: Ganglioneuroblastoma of filum terminale: case report.
abstract: OBJECTIVE
  Neuroblastic tumors can be classified as neuroblastoma, ganglioneuroblastoma (GNB), or ganglioneuroma. Ganglioneuroblastomas consist of small, round, immature neuroblast cells and matured ganglion cells. They are most commonly found in the mediastinum and retroperitoneum; intraspinal GNBs are extremely rare. There are only 5 cases of intraspinal GNB reported in the English literature. The authors report a case of GNB of the filum terminale. The duration of follow-up after the initial treatment is longer than in any other published reports.
  
  
  METHODS
  A 36-year-old woman underwent resection of an intradural extramedullary tumor at L1-2 in 1993. Pathological diagnosis was GNB. After surgery, her symptoms resolved and she recovered to a normal condition. In 2009, when she was 53 years old, she presented to the hospital with paralysis of both legs. Magnetic resonance imaging suggested recurrence of spinal tumor. She underwent subtotal resection of the tumors, followed by 4 weeks of radiation therapy.
  
  
  RESULTS
  Neurological symptoms improved, and, after radiation therapy, the patient was able to walk with a crutch. Histological investigation of the excised tumor indicated that it was a nodular type GNB, which was consistent with the diagnosis from the time of the initial surgery in 1993. Follow-up MRI studies showed no growth of residual tumors in the 3 years following the surgery.
  
  
  CONCLUSIONS
  The authors present a rare case of spinal GNB. The duration of follow-up after the initial surgery in 1993 represents the longest description of clinical course after treatment for spinal GNB.
authors.affiliation: Departments of 1 Orthopedic Surgery and.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Okudera
authors.forename: Naohisa
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: Taku
authors.initials: T
authors.lastname: Sugawara
authors.forename: Michio
authors.initials: M
authors.lastname: Hongo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasukawa
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Shimada
mesh_terms: D002420:Cauda Equina / Q000473:pathology* / Q000601:surgery*; D005260:Female; D018305:Ganglioneuroblastoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery
keywords: GNB = ganglioneuroblastoma; filum terminale; ganglioneuroblastoma; oncology; radiotherapy; spine; surgery