Rachel Engelberg, MD
New York-Presbyterian/Weill Cornell Medicine
New York, New York
Rachel Engelberg, MD1, David Wan, MD2
1New York Presbyterian - Weill Cornell Medical Center, New York, NY; 2Weill Cornell Medical College, New York, NY
Introduction: Ganglioneuromas are benign tumors of the sympathetic nervous system that carry a great prognosis with almost no change in clinical mortality. They are often asymptomatic, though can present with symptoms such as abdominal pain or constipation if large enough. These tumors are exceedingly rare and are curative with resection. Currently, there are no clear guidelines in the literature on appropriate surveillance for such patients. Here we present a case of a ganglioneuroma found in an asymptomatic patient on routine screening colonoscopy.
Case Description/Methods: A 78-year-old woman with a past medical history significant for atrial fibrillation and hypertension was referred for routine screening colonoscopy for colorectal cancer. The patient was asymptomatic and had no diarrhea, constipation, hematochezia, or melena. She had no family history of gastrointestinal diseases nor record of any previous colonoscopy. Upon colonoscopy, four polyps were visualized on colonoscopy within the hepatic flexure, splenic flexure, descending colon and sigmoid colon, as well as diverticulosis in the sigmoid and ascending colon. Polyps were fully resected and retrieved with cold snare. The pathology returned with normal colonic mucosa within the splenic flexure, tubular adenomas in the hepatic flexure and descending colon, and a ganglioneuroma in the sigmoid colon. The patient was recommended for repeat surveillance colonoscopy in three years based on the adenoma.
Discussion: Ganglioneuromas are an exceedingly rare benign neoplasm of the colon, often with no clinical symptoms as seen in our patient. Therefore, these tumors are primarily diagnosed on routine screening colonoscopy. Given the rarity of this clinical entity, there are no current guidelines available for how to appropriately follow these patients. Such tumors have an excellent clinical prognosis and tend not to recur, therefore it is generally accepted that these patients require no surveillance screening. Given that our patient had concomitant tubular adenomas, she was recommended for follow up colonoscopy in three years. Resection of ganglioneuromas is curative and thus the mainstay of treatment. Our patient is unique as identifying these tumors is rare and infrequently reported in the literature.
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Citation: Rachel Engelberg, MD; David Wan, MD. P1996 - GANGLIONEUROMA FOUND ON ROUTINE SCREENING COLONOSCOPY. Program No. P1996. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.