Ganglioneuroblastoma of the Posterior Mediastinum in a Child.

1. ‫الرحيم‬ ‫الرحمن‬ ‫هللا‬ ‫بسم‬
Ganglioneuroblastoma of the
Posterior Mediastinum with an
Orbital Metastasis in a Child
Prof. Abdulsalam Y Taha
College of Medicine
University of Sulaimani
2022 1

2. The Case
 A 4-years old boy was referred to the
Department of Thoracic Surgery,
Sulaymaniyah Teaching Hospital,
Sulaymaniyah, Region of Kurdistan,
Iraq on 15th of October 2008 shortly
after starting chemotherapy for a
suspected metastatic orbital mass. At
the same time, the patient was
discovered to have a big mass the in
right thoracic cavity as well. 2

3. 3
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4. Orbital Mass
4
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5. 5
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6. Right lower zone opacity
6
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7. CXR revealed a
big rounded
well-defined
opacity in the
posterior
mediastinum
7
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8. Thoracic CT scan suggested a
neuroblastoma
8
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9. 9
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10. 10

11. Abdominal US Report
11

12. Abdominal US suspected a
right suprarenal tumour
12
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13. However, CT scan of the abdomen
revealed normal adrenals
13
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14. 14

15. Right
thoracotomy
was performed
15
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16. A big solid tumour mass was found in
the posterior mediastinum with
engorged blood vessels on its surface
and with a wide base. 16
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17. The mass
was totally
resected
17
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18. 18
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19. Histopathological exam confirmed the
diagnosis of ganglioneuroblastoma
19
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20. Postoperative course was smooth apart from a
leak of chyle (due to mild thoracic duct
injury) which stopped after several days of
chest tube drainage. 20
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21. 21
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22. Comment
 Neuroblastoma is predominantly a tumour
of early childhood, which metastasises to
the orbits. In such cases, ophthalmologists
are involved in the multidisciplinary
management [1].
 Between 10–20% of neuroblastoma cases
have orbital metastases. Neuroblastoma
originates in the adrenal medulla or the
paraspinal sites where sympathetic nervous
system tissue is present [1]. 22

23. Bibliography
[1] Ahmed, S., Goel, S., Khandwala, M.
et al. Neuroblastoma with orbital
metastasis: ophthalmic presentation
and role of ophthalmologists. Eye 20,
466–470 (2006).
https://doi.org/10.1038/sj.eye.6701912
23