Abstract:
Retroperitoneal ganglioneuroma is a rare neuroectodermal tumor with a benign nature. We performed a literature review among 338 studies. We included 9 studies, whose patients underwent CT and/or MRI to characterize a retroperitoneal mass, which was confirmed to be a ganglioneuroma by histologic exam. The most common features of ganglioneuroma are considered to be a solid nature, oval/lobulated shape, and regular margins. The ganglioneuroma shows a progressive late enhancement on CT. On MRI it appears as a hypointense mass in T1W images and with a heterogeneous high-intensity in T2W. The MRI-\"whorled sign\" is described in the reviewed studies in about 80% of patients. The MRI characterization of a primitive retroperitoneal cystic mass should not exclude a cystic evolution from solid masses, and in the case of paravertebral location, the differential diagnosis algorithm should include the hypothesis of ganglioneuroma. In our case, the MRI features could have oriented towards a neurogenic nature, however, the predominantly cystic-fluid aspect and the considerable longitudinal non-invasive extension between retroperitoneal structures, misled us to a lymphatic malformation. In the literature, it is reported that the cystic presentation can be due to a degeneration of a well-known solid form while maintaining a benign character: the distinguishing malignity character is the revelation of immature cells on histological examination.
摘要:
腹膜后神经节神经瘤是一种罕见的神经外胚层肿瘤,具有良性性质。我们对338项研究进行了文献综述。我们纳入了9项研究,患者接受了CT和/或MRI以表征腹膜后肿块,组织学检查证实为神经节细胞瘤。神经节神经瘤最常见的特征被认为是固体性质,椭圆形/分叶状,和正常的利润率。节细胞神经瘤在CT上显示进行性晚期增强。在MRI上,它在T1W图像中表现为低信号肿块,在T2W中表现为不均匀的高强度。在大约80%的患者的综述研究中描述了MRI-“轮状体征”。原始腹膜后囊性肿块的MRI特征不应排除实性肿块的囊性演变。在椎旁位置的情况下,鉴别诊断算法应包括节细胞神经瘤的假设。在我们的案例中,MRI特征可能是神经源性的,然而,主要是囊性液体方面和腹膜后结构之间相当大的纵向非侵入性延伸,误导我们淋巴畸形.在文学中,据报道,囊性表现可能是由于众所周知的固体形式的变性,同时保持良性特征:区别的恶性特征是组织学检查中未成熟细胞的揭示。