title: Retroperitoneal paravertebral ganglioneuroma: a multidisciplinary approach facilitates less radical surgery.
abstract: BACKGROUND
  Ganglioneuroma (GN) of the adult is a rare benign tumour originating from neural crest-derived cells. In most cases, GN is found in the mediastinum or retroperitoneum incidentally and may present with unspecific symptoms caused by space-occupying effects. The correct diagnosis of a retroperitoneal mass is still a challenge. Nevertheless, a preoperatively confirmed diagnosis of GN may support the concept of a less radical approach and may help to prevent unnecessary morbidity or loss of function.
  
  
  METHODS
  We report a case of a symptomatic retroperitoneal paravertebral GN in a 33-year-old woman. She has been referred with abdominal discomfort, lancinating pain in the right leg, headache and nausea. Magnetic resonance imaging revealed a solid paravertebral tumour adjacent to the psoas muscle. Computed tomography-guided core needle biopsy yielded the diagnosis of GN. The tumour was resected completely via a laparotomy. Immunohistopathological examinations confirmed a benign GN.
  
  
  CONCLUSIONS
  Diagnostic studies and therapeutic interventions of retroperitoneal GN are discussed. In our case, a core needle biopsy preceding complete resection was helpful to prevent too extensive surgical approach.
authors.affiliation: Department of General, Visceral and Cancer Surgery, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Paasch
authors.affiliation: Institute of Pathology, Health Care Centre of the Municipal Hospital Brandenburg, Clinic of Medical University of Brandenburg, Brandenburg, Germany.|Institute of Neuropathology, University Hospital Münster, Münster, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Harder
authors.affiliation: Institute of Pathology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Esther Jasmin
authors.initials: EJ
authors.lastname: Gatzky
authors.affiliation: Institute of Radiology, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Ehssan
authors.initials: E
authors.lastname: Ghadamgahi
authors.affiliation: Department of Neurosurgery, HELIOS Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Spuler
authors.affiliation: Department of General, Visceral and Cancer Surgery, HELIOS Klinikum Berlin-Buch, Berlin, Germany. robert.siegel@helios-kliniken.de.|Faculty of Health, Witten/Herdecke University, Witten, Germany. robert.siegel@helios-kliniken.de.
authors.forename: Robert
authors.identifier: http://orcid.org/0000-0003-3615-7969
authors.initials: R
authors.lastname: Siegel
mesh_terms: D000328:Adult; D062005:Biopsy, Large-Core Needle; D000072716:Cancer Pain / Q000209:etiology; D005260:Female; D005729:Ganglioneuroma / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D019584:Hot Flashes / Q000209:etiology; D006801:Humans; D061705:Image-Guided Biopsy; D007813:Laparotomy; D008279:Magnetic Resonance Imaging; D008866:Microsurgery; D012186:Retroperitoneal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D012187:Retroperitoneal Space / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D057832:Watchful Waiting
keywords: Ganglioneuroma; Paravertebral tumour; Retroperitoneal tumour