Adult-onset adrenal ganglioneuroblastoma - Bone metastasis two years after surgery: report of a case.

Ganglioneuroblastoma (GNB) is a common type of tumor in children but is rarely seen in adults. This report presents a case of an adrenal GNB in a 53-year-old man with bone metastasis after surgery. The patient experienced an increased frequency of urination and was found to have a nonfunctioning tumor in the right adrenal gland. The tumor was 11 cm in diameter with no local invasion or distant metastasis, and was completely removed. Histologically, on gross examination the tumor contained a visible neuroblastomatous nodule with ganglioneuromatous component, and was diagnosed as GNB nodular classical type. Two years after surgery, multiple metastatic lesions were found in the patient's lumbar spine. Only 48 GNB cases have been reported in the literature. According to these reports, large GNB tumors, more than 8 cm in diameter, tend to arise from the retroperitoneal cavity and develop to metastasize to nearby bone or lymph nodes. Because the prognosis was not favorable, despite surgery and radiation therapy or chemotherapy, it is necessary to closely follow patients with large GNB tumors.