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The Journal of Bone and Joint Surgery 81:1589-95 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Symptomatic Ganglioneuroma of Bone. A Case Report*

KAI MITHÖFER, M.D.{dagger}, ERIC F. GRABOWSKI, M.D., SC.D.{dagger}, ANDREW E. ROSENBERG, M.D.{dagger}, DANIEL P. RYAN, M.D.{dagger} and HENRY J. MANKIN, M.D.{dagger}, BOSTON, MASSACHUSETTS

Investigation performed at Massachusetts General Hospital and Harvard Medical School, Boston


   Introduction
 
Ganglioneuromas are uncommon benign tumors that are thought to be derived from the nonchromaffin cells of the sympathetic nervous system. Primary ganglioneuromas usually arise from sympathetic elements located between the craniovertebral junction and the pelvis. These lesions tend to grow slowly, typically are dumbbell-shaped, and may cause progressive compression of spinal nerve roots or erosion into adjacent osseous structures10,19,22,26. Primary soft-tissue ganglioneuroma with secondary erosion into bone should be differentiated from ganglioneuroma that has metastasized to bone. The latter phenomenon is the result of skeletal metastasis of neuroblastoma with subsequent spontaneous maturation of this highly malignant tumor to ganglioneuroma. To the best of our knowledge, only two cases of ganglioneuroma of bone developing from spontaneous differentiation of metastatic neuroblastoma have been reported in the literature9,32. We describe a case of disseminated ganglioneuroma of the skeleton that presented with an impending pathological fracture and that closely mimicked the clinical . . . [Full Text of this Article]


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