Ganglioneuroma is a formation formed from ganglia, nervous sympathetic nodules. The disease was first described by Loretz in 1870.
The structure of the tumor can be different and depends on the nature of the constituent cells. Mature ganglioneuromes are single and have sizes from a pin to a child's head.
Statistics and localization
Most common in the left half of the trunk. In young women, education is more common than in men. Half the cases are found in people younger than 20 years.
Causes of the occurrence of
Some scientists believe that the cause of the occurrence is physical overexertion. This is due to the fact that the disease is often found on the back of the hands and feet of typists and pianists.
Presumably, formation appears at the site of the tendon rupture and cyst formation.
The second cause is disorders that occur in the intrauterine development during the formation of the nervous system. This is confirmed by the presence of other congenital anomalies.
Often in patients, there is assimilation of the atlas, cleft lip, wolf mouth and other diseases. It leads to this adverse effect: radioactive irradiation, rubella, chlamydia, intoxication, fetal hypoxia.
Symptoms of ganglioneuroma
Sometimes the disease is asymptomatic, so it is detected posthumously. Their manifestations depend on the location, the size of the tumor.
Compression of individual organs can lead to loss of the ability to move. Especially if the disease is not detected for a long time. Such a violation may remain after treatment.
The general condition of the patient remains satisfactory for a long time. As education grows, fatigue, weakness, weight loss, symptoms of body intoxication appear.
The retroperitoneal space
In the initial stages, painful sensations in the abdomen are noted. They can be wandering or localized. There is discomfort, aching pain in the lower back, swelling. With large tumors, a person feels nauseous, a feeling of heaviness in the abdomen.
Brain
The gangliosithoma is found in 0.1-0.4% of all tumors inside the skull. It appears in any part of the brain, but more often:
- at the bottom of the 3 ventricles,
- in the hypothalamus,
- in the subcortical structures.
It usually has a size of not more than 4 cm. The size increase is slow.
No specific symptoms, therefore, signs, as with other intracerebral tumors:
- Appearance of blunt, bursting pain, which in the initial stages is episodic. Soreness often appears in the prone position on the affected side.
- Vertigo. They have a paroxysmal character and are accompanied by nausea, noise in the ears.
- Often there is vomiting, not associated with food intake. It also accompanies periods of headaches. When a 4 ventricle or cerebellum lesion occurs, vomiting occurs when the position of the body changes.
- In rare cases, mental disorders develop. They are manifested by a decrease in attention, memory, and emotional manifestations. Sometimes accompanied by hallucinations, delirium.
Spine
Ganglioneuromas are most often found in the spine. Such formations have the form of an hourglass and consist of two nodes.
With increasing education, there are violations of control over the functions of the pelvic organs.
Gradually, the sensitivity of the hands / legs, other areas of the body, disappears.
During the growth of the tumor, nonspecific symptoms appear in the spinal cord: soreness in the site of localization, conductive disorders, defects below the level of the lesion.
Diagnosis
Tumor examination is difficult due to the lack of characteristic symptoms. Often it is found during X-ray studies. The best tools are:
- CT,
- MRI,
- ultrasound.
To determine the nature of cells, the level of hormones and other compounds, urine and blood tests are prescribed. Neurologists, gastroenterologists, urologists and other specialists can randomly detect lesions.
To confirm the diagnosis, histological examination of the tissue is performed. It is taken with:
- punctuation biopsy of the vertebra,
- stereotactic brain biopsy.
The first method in modern clinics is performed without a soft tissue incision using a needle for bone biopsy or a trocar. In some cases, the procedure is carried out under the control of computed tomography.
A stereotactic biopsy is performed in a situation where other methods do not provide accurate information. The procedure is carried out under general anesthesia. The skin, soft tissues of the head are cut, and a hole a few millimeters is made in the skull. A needle is inserted into it. After the procedure, the wound is sutured.
Treatment of the gangioneuroma
The tumor is treated exclusively surgically.
Usually, manipulation requires two surgical access: laminectomy, sternum opening or peritoneum. The first method allows to expand the cavity of the canal and eliminate its squeezing. Also, the procedure opens the access to the spinal cord.
The removal of the ganglioneuroma in the skull is a partial removal and prevention of spreading to the brain tissue. Sometimes such manipulation is supplemented by shunting. It is the use of drainage tubes with a one-way valve.
Forecast
Despite the benign course of the disease, a histological study is conducted to exclude the degeneration of the tumor into ganglionic fibroblasts.
If mature tumors are small and completely removed, then the prognosis is favorable.
Relapses are observed in rare cases. In all other situations, regular monitoring is required.