Rare Images of a Peripancreatic Ganglioneuroma.

A 31-year-old man was referred for the examination of a cyst-like lesion at the pancreatic head. Computed tomography demonstrated a well-demarcated, low-attenuated mass between the pancreatic head and the liver, 60 mm in diameter (Picture 1A). Abdominal ultrasound (Picture 1B) showed intra-tumorous dotty enhancement, which was confirmed by magnetic resonance imaging (MRI) (plain: Picture 1C, enhanced: Picture 1D). The tumor showed a low-intensity signal on T1-weighted imaging, high-intensity signal on T2-weighted imaging, and weakly repressed diffusing capacity (Picture 1E). Endoscopic ultrasonography demonstrated heterogeneous high-echoic dots in the low-echoic margin (Picture 1F). Preoperatively, ganglioneuroma, schwannoma and lymphepithelial cyst were suspected. Laparotomy was performed, and the pathology revealed ganglioneuroma (Picture 2, arrows indicating a vein). Ganglioneuroma is a rare benign tumor originating from the sympathetic nerve. It mostly develops in the mediastinum and retroperitoneum and is often diagnosed incidentally during childhood (1,2). A ganglioneuroma should be included in the differential diagnosis of peripancreatic tumors.

Picture 1.

Picture 2.

The authors state that they have no Conflict of Interest (COI).