Robotic and standard surgical intervention as adjunct therapies for retroperitoneal ganglioneuroma resection: a case report

BMC Surgery

Sabrina Araujo de Franca¹  David S. L. Parra¹  Wagner M. Tavares²  Manoel J. Teixeira³  Sergio R. R. Araújo⁴  Amsterdam S. Vasconcelos⁵ 

[1] Department of Research of IPSPAC, Instituto Paulista de Saúde Para Alta Complexidade, 199 Padre Anchieta Avenue, Room 2, Jardim, 09090-710, Santo André, SP, Brazil;Department of Research of IPSPAC, Instituto Paulista de Saúde Para Alta Complexidade, 199 Padre Anchieta Avenue, Room 2, Jardim, 09090-710, Santo André, SP, Brazil;Institute of Neurology, University of São Paulo, 255 Dr. Enéas de Carvalho Aguiar avenue, Cerqueira César, 05403-900, São Paulo, SP, Brazil;Institute of Neurology, University of São Paulo, 255 Dr. Enéas de Carvalho Aguiar avenue, Cerqueira César, 05403-900, São Paulo, SP, Brazil;LabPac, Laboratório Anatomia Patológica Imuno-Histoquímica Citopatologica, 75 Calixto da Mota Street, Vila Mariana, 04117-100, São Paulo, SP, Brazil;Surgical Oncology Department, Hospital Santa Catarina, 200 Paulista Avenue, Bela Vista, 01310-000, São Paulo, SP, Brazil;

关键词: Adjunct surgery;    Case report;    Ganglioneuroma;    Retroperitoneal;    Robotic assisted surgery;   

DOI  :  10.1186/s12893-021-01146-x

来源: Springer

【 摘 要 】

BackgroundGanglioneuroma (GN) is ranked by the International Neuroblastoma Pathology Classification as a benign tumor. It can occur anywhere along the sympathetic nerve chain and surgical excision is the treatment of choice.Case presentationAn 18-year-old female patient sought medical assistance after 6 months of constant dorsal and back pain radiating from the thoracic region to the right abdominal flank. Magnetic resonance imaging revealed a solid nodular lesion with heterogeneous post-contrast enhancement and lobulated contours, centered on the right foramina of D12–L1, with a projection to the intracanal space, which compressed and laterally displaced the dural sac and had a right paravertebral extension between the vertebral bodies of D11 and superior aspect of L2. Ganglioneuroma was diagnosed using immunohistochemical analysis. It was decided to use a surgical approach in two stages: robot assisted for the anterior/retroperitoneal mass and a posterior hemilaminectomy/microsurgical approach to attempt total resection, avoiding the traditional anterior thoracoabdominal surgical incision and optimizing the patient’s postoperative outcomes. No postoperative adverse events were noted, and the patient was discharged on postoperative day 5.ConclusionThis retroperitoneal GN presentation was peculiar because it originated at the D12 nerve root, which extended to the retroperitoneal space and inside the spinal canal. We hope that our case report can assist future decisions in similar circumstances.

【 授权许可】

CC BY