Surgical management of giant cervical ganglioneuroma: A case report and literature review

Ganglioneuroma is a very rare tumor and it grows very slowly. It may take years before any symptom develop. Although it is a benign tumor, it may grow to become quite huge. If it presents in the cervical spine area and causes spinal cord or nerve root compression, severe symptoms and signs will be apparent. When patients with such symptoms and signs are encountered, surgical intervention is necessary. We report a huge cervical spine ganglioneuroma case, a patient who has myelopathy, radiculopathy and sympathetic sign. According to tumor location and size, we planned to perform anterior and posterior surgical approaches at one stage. Posterior instrumentation with lateral mass screws after hemilaminectomy was performed at first. Anterior partial vertebrectomy, tumor removal, and fusion with strut allograft were then accomplished. After surgery, the patient's neurologic functions improved. Magnetic resonance imaging (MRI) repeated 3 months later revealed the tumor was completely removed and no spinal cord compression was observed. Surgical excision is indicated in this patient. We should take tumor location and size into consideration to decide appropriate surgical approach.