• Seung Hun Kang, Sang Min Lee, Doo Hoe Ha, and Hye Jin Lee.
• Department of Radiology, CHA Bundang Medical Center, CHA University, School of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, 13496, Gyeonggi-do, Republic of Korea.
• Eur Spine J. 2018 Jul 1; 27 (Suppl 3): 520-525.

BackgroundGanglioneuromas are rare, benign, well-differentiated tumors arising from neural crest cells that commonly occur in the posterior mediastinum, retroperitoneum, cervical spine, and adrenal gland. We report an unusual case of an extensive spinal extradural ganglioneuroma, circumferentially and longitudinally affecting the extradural space of the lumbar spine and continuously invading bilateral psoas muscles.Case DescriptionA 32-year-old man presented with a 1-week history of abdominal pain and diarrhea. Radiographs revealed scalloping of the posterior surfaces of the L2 and L3 vertebral bodies and widening of L2-3 and L3-4 bilateral intervertebral foramina. Computed tomography scans and magnetic resonance imaging showed a well-defined lobulated extradural mass from L1 to L4 and a continuously forming mass in the psoas muscles through L2-3 bilateral neural foramina. The mass demonstrated homogeneously isointense signal on T1-weighted images, inhomogeneously hyperintense-to-isointense signal on T2-weighted images, and inhomogeneous enhancement on fat-suppressed contrast-enhanced T1-weighted images. Radiologic diagnosis included spinal epidural lymphoma. Percutaneous biopsy with sonographic guidance was performed, and the mass was diagnosed on pathological examination as a ganglioneuroma.ConclusionsThis is the first known reported case in the literature of a spinal extradural ganglioneuroma with circumferentially and longitudinally extensive involvement of the extradural space and a large psoas mass.

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