Combined exploratory laparotomy, transpsoas, and thoracic approach to resection of a giant spinal ganglioneuroma: illustrative case.

Autor:	Deng H; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Habib A; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.; 2Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and., Andrews EG; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Zhang X; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., McCarthy DJ; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Wei Z; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Dhupar R; Departments of3Thoracic Surgery and., Choudry MH; 4Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Zinn PO; 1Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.; 2Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2023 Jan 09; Vol. 5 (2). Date of Electronic Publication: 2023 Jan 09 (Print Publication: 2023).
DOI:	10.3171/CASE22453
Abstrakt:	Background: Ganglioneuromas are rare peripheral nervous system tumors of neural crest origin. Most are often asymptomatic and incidentally found, but large tumors can cause mass effect. Herein, the authors report a case of a giant ganglioneuroma that arose from the lumbar foramina into the retroperitoneal and thoracic cavities. Observations: A 62-year-old female presented with low back pain, left lower extremity swelling, and increased sensation of an abdominal mass. Surgical treatment options were reviewed with the patient and coordinated care was planned by surgical oncological specialists. The patient opted for multistage exploratory laparotomy for abdominal mobilization, diaphragm resection, and en bloc resection with neuromonitoring. After surgery, the patient experienced significant improvement in symptoms. Lessons: A combined surgical exposure involving gastrointestinal, thoracic, and neurological surgeons can be important in the safe resection of ganglioneuromas that span multiple body cavities. Hence, a thorough preoperative assessment could help plan surgery accordingly.
Databáze:	MEDLINE
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