Surgical management of a giant cervical ganglioneuroma

An 18-year-old patient presented with a major complaint of a mass in the right side of the neck. At the previous clinic, the patient underwent an open biopsy because the mass could not be diagnosed by fine needle aspiration. The patient was introduced to our institution after mass was diagnosed as ganglioneuroma by open biopsy. In our outpatient clinic, magnetic resonance imaging (MRI) and computed tomography (CT) were performed. Gradual growth of the mass was accompanied by sleep apnea syndrome. Ultimately, the patient was only able to sleep with nasal continuous positive airway pressure. Pathological examination confirmed the ganglioneuroma. MRI revealed expansion of the ganglioneuroma from the nasopharynx to the right upper mediastinum, occupying the surroundings of the contralateral carotid artery via the retropharyngeal space. CT revealed a tumor mass of 160 mm × 60 mm × 190 mm in size. The mass was surgically resected without any postoperative neurological disorder including Horner syndrome. The clinical course was successful without recurrence. This is the first report of a successful treatment of a large ganglineuroma that had continuously expanded to the contralateral neck via the retropharyngeal space.