J Korean Neurosurg Soc.  2015 Mar;57(3):211-214. 10.3340/jkns.2015.57.3.211.

A Malignant Transformation of a Spinal Epidural Mass from Ganglioneuroblastoma to Neuroblastoma

• Akcakaya M
• Bilgic B
• Aras Y
• Izgi N

• KMID: 2191224
• DOI: http://doi.org/10.3340/jkns.2015.57.3.211

Abstract

Ganglioneuromas are benign tumors. Surgical excision is the treatment of choice with very good prognosis. However, neuroblastomatous malignant transformation of ganglioneuromas was previously reported. We report a patient with spinal neuroblastoma recurrent from a ganglioneuroblastoma after disease free survival of 13 years. This is one of the rare examples of spinal neuroblastoma and to our knowledge the second case report with malignant transformation from a ganglioneuroblastoma or a ganglioneuroma. The present case is the only report in the literature with further genetic investigations.

Keyword

Ganglioneuroblastoma; Neuroblastoma; Malignant transformation; Spinal tumor

MeSH Terms

Disease-Free Survival
Ganglioneuroblastoma*
Ganglioneuroma
Humans
Neuroblastoma*
Prognosis

Figure

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  Fig. 1 On T2-weighted, axial MR image of the mass lesion with heterogeneous signal intensity is detected in the left D11-12 neural foramen (arrow). There is also some enlargement and remodeling of the foramen.

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  Fig. 2 Photomicrograph showing tumor cells, which are round blastic in nature/appearance, and in between scattered mature ganglion cells (A : H&E, original magnification, ×200). The tumor cells were positive for CD56 (B : original magnification, ×100).

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  Fig. 3 A : T1-weighted, postcontrast axial MR image performed 13 years later despicts progression of the former lesion at D10 vertebral level with extension into the extradural space on the right and crossing of the midline towards the leftside. B : T1-weighted, postcontrast sagittal image also shows involvement of the D10 vertebral body with low signal intensity due to tumor cell infiltration.

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  Fig. 4 Photomicrograph showing a round cell malignant tumor without mature component (A : H&E, original magnification, ×100). The tumor cells showed positive immunoreactivity for CD56 (B : original magnification, ×100) and synaptophysin (C : original magnification, ×100).

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