Total laparoscopic excision of retroperitoneal ganglioneurom
Ganglioneuromas are rare benign tumors originating from neural crests and typically affect young adults. Adaptation of laparoscopic surgery should be considered based on organ or vessel invasion and adhesion around the tumor. This approach is less invasive and achieves good cosmetic outcomes.

In the literature, the number of retroperitoneal masses reported is quite limited. Investigators report a case of laparoscopic excision of a retroperitoneal ganglioneuroma.

The patient was a 40-year-old woman who visited a nearby clinic with anorexia and vomiting. She was referred to the hospital after the detection of an abdominal mass.

Enhanced CT showed a lobule mass of 107?×?42?mm in size, with internal inhomogeneity and mild delayed enhancement on the retroperitoneal side of the left abdominal lesion. MRI showed a mass with low intensity and partial high intensity on T2 weighted image (T2WI). In addition, PET-CT detected slight fluorodeoxyglucose (FDG) accumulation (standardized uptake value(SUV) max: 3.01) in the same lesion. Based on these findings, they suspected a retroperitoneal tumor. Laparoscopic excision was performed via 5 ports. The extracted tissue was a well-defined mass of 110?×?70?mm. The tumor exceeded 10?cm.

The pathological diagnosis was ganglioneuroma, with no obvious malignancy.

It was suggested that adaptation of laparoscopic surgery should be considered based on the observation of organ invasion or vessel invasion and adhesion around the tumor, rather than based on the diameter of the tumor.

This approach is less invasive than conventional laparotomy methods and achieves good cosmetic outcomes. Thus, totally laparoscopic procedures should be considered more often for the treatment of retroperitoneal tumors.

International Journal of Surgery Case Reports
Source: https://doi.org/10.1016/j.ijscr.2021.106053
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