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Solitary Colonic Ganglioneuroma: A Rare Incidental Finding of Hematochezia.

Abraham G, Prakash SR - Case Rep Gastrointest Med (2015)

Bottom Line: It is rare to encounter GN in the gastrointestinal tract.GNs are categorized into three different morphological subtypes, namely, polypoid GN, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis.Due to a lack of guidelines, we reviewed the literature to discuss treatment and other associated conditions for GN.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Gastroenterology and Hepatobiliary Disease, New York Methodist Hospital, 506 6th Street, Brooklyn, NY 11215, USA.

ABSTRACT
Ganglioneuromas (GNs) are hamartomatous tumors derived from the autonomic nervous system. It is rare to encounter GN in the gastrointestinal tract. Patients with these tumors usually present with abdominal pain, constipation, ileus, weight loss, or even bleeding. GNs are categorized into three different morphological subtypes, namely, polypoid GN, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis. We present a case of hematochezia from GN in a colon polyp discovered on diagnostic colonoscopy. Due to a lack of guidelines, we reviewed the literature to discuss treatment and other associated conditions for GN.

No MeSH data available.


Related in: MedlinePlus

Hematoxylin and eosin stain of the colonic ganglioneuroma. Ganglion and stromal cells are present in the lamina propria. Magnification: 100x.
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fig3: Hematoxylin and eosin stain of the colonic ganglioneuroma. Ganglion and stromal cells are present in the lamina propria. Magnification: 100x.

Mentions: Patients with solitary GN are often asymptomatic but can present with constipation, abdominal pain, weight loss, obstruction, ileus, and bleeding depending on the lesions size and location. Treatment of solitary GN involves endoscopic resection via hot biopsy forceps. Histology of the lesion will show multiple spindle cells on hematoxylin and eosin stain and will be immunoreactive to S100 protein stain and neuron-specific enolase (see Figures 2, 3, and 4). Currently, no consensus recommendation exists on management of polypoid GN; however, it would be beneficial to schedule a follow-up surveillance colonoscopy to ensure complete excision of the lesion. A few sparse cases of colon cancer coexisting with ganglioneuromatous polyposis or diffuse ganglioneuromatosis have been reported [6–8]. However, there is a lack of data on the association of polypoid GN and colon cancer. Patients should be screened for other associated genetic syndromes and for tumors in other sites like the thyroid, colon, breast, and uterus [9]. Urine vanillylmandelic acid, serum calcitonin, and serum calcium should also be performed to exclude MEN 2B. Our patient had an endoscopic ultrasound with colonoscopy to reevaluate margins of excision, which did not reveal any residual tissue.


Solitary Colonic Ganglioneuroma: A Rare Incidental Finding of Hematochezia.

Abraham G, Prakash SR - Case Rep Gastrointest Med (2015)

Hematoxylin and eosin stain of the colonic ganglioneuroma. Ganglion and stromal cells are present in the lamina propria. Magnification: 100x.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4446460&req=5

fig3: Hematoxylin and eosin stain of the colonic ganglioneuroma. Ganglion and stromal cells are present in the lamina propria. Magnification: 100x.
Mentions: Patients with solitary GN are often asymptomatic but can present with constipation, abdominal pain, weight loss, obstruction, ileus, and bleeding depending on the lesions size and location. Treatment of solitary GN involves endoscopic resection via hot biopsy forceps. Histology of the lesion will show multiple spindle cells on hematoxylin and eosin stain and will be immunoreactive to S100 protein stain and neuron-specific enolase (see Figures 2, 3, and 4). Currently, no consensus recommendation exists on management of polypoid GN; however, it would be beneficial to schedule a follow-up surveillance colonoscopy to ensure complete excision of the lesion. A few sparse cases of colon cancer coexisting with ganglioneuromatous polyposis or diffuse ganglioneuromatosis have been reported [6–8]. However, there is a lack of data on the association of polypoid GN and colon cancer. Patients should be screened for other associated genetic syndromes and for tumors in other sites like the thyroid, colon, breast, and uterus [9]. Urine vanillylmandelic acid, serum calcitonin, and serum calcium should also be performed to exclude MEN 2B. Our patient had an endoscopic ultrasound with colonoscopy to reevaluate margins of excision, which did not reveal any residual tissue.

Bottom Line: It is rare to encounter GN in the gastrointestinal tract.GNs are categorized into three different morphological subtypes, namely, polypoid GN, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis.Due to a lack of guidelines, we reviewed the literature to discuss treatment and other associated conditions for GN.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Division of Gastroenterology and Hepatobiliary Disease, New York Methodist Hospital, 506 6th Street, Brooklyn, NY 11215, USA.

ABSTRACT
Ganglioneuromas (GNs) are hamartomatous tumors derived from the autonomic nervous system. It is rare to encounter GN in the gastrointestinal tract. Patients with these tumors usually present with abdominal pain, constipation, ileus, weight loss, or even bleeding. GNs are categorized into three different morphological subtypes, namely, polypoid GN, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis. We present a case of hematochezia from GN in a colon polyp discovered on diagnostic colonoscopy. Due to a lack of guidelines, we reviewed the literature to discuss treatment and other associated conditions for GN.

No MeSH data available.


Related in: MedlinePlus