Ruiz-Tovar J, Gamallo-Amat C

Language: Spanish
References: 10
Page: 274-277
PDF size: 384.12 Kb.

ABSTRACT

Background: Retroperitoneal ganglioneuromas are rare entities. Their treatment is complete surgical resection. Due to the proximity to major vessels, variable location and unknown malignant status, surgeons are often reluctant to use a laparoscopic approach for the resection of retroperitoneal masses. To our knowledge, only five cases of laparoscopic resection of retroperitoneal ganglioneuroma have been previously reported.
Clinical case: We present the case of a 53-year-old woman who complained of intense, diffuse, stabbing, intermittent, nonradiating abdominal pain sharpest in both flanks during the preceding 6 months. A contrast-enhanced CT scan showed a well-defined, homogeneous 4-cm mass located in the retroperitoneum, extending from the exit of the inferior mesenteric vessels up to the renal veins. A laparoscopic anterior transperitoneal approach was performed with infraumbilical Hasson trocar and two 10-mm trocars in both iliac fossas. Operation time was 90 min. The patient was discharged on the second postoperative day. Histopathology reported a retroperitoneal ganglioneuroma. After 12 months follow-up, the patient is alive and disease-free.
Conclusions: For digestive surgeons not used to the retroperitoneal access through the lateral position, the anterior transperitoneal approach can be a safe alternative for the resection of retroperitonal neoplasms.

REFERENCES

1. Misra MC, Bhattacharjee HK, Hemal AK, Bansal VK. Laparoscopic management of rare retroperitoneal tumors. Surg Laparosc Endosc Percutan Tech 2010;20:e117-e122.

2. Sasaki A, Suto T, Nitta H, Shimooki O, Obuchi T, Wakabayashi G. Laparoscopic excision of retroperitoneal tumors: report of three cases. Surg Today 2010;40:176-180.

3. Cadeddu MO, Mamazza J, Schlachta CM, Seshadri PA, Poulin EC. Laparoscopic excision of retroperitoneal tumours: technique and review of the laparoscopic experience. Surg Laparosc Endosc Percutan Tech 2001;11:144-147.

4. Kang CM, Kim DH, Seok JY, Lee WJ. Laparoscopic resection of retroperitoneal benign schwannoma. J Laparoendosc Adv Surg Tech 2008;18:411-416.

5. Yamaguchi K, Hara I, Takeda M, Tanaka K, Yamada Y, Fujisawa M, et al. Two cases of ganglioneuroma. Urology 2006;67:622.

6. Oue T, Yoneda A, Sasaki T, Tani G, Fukuzawa M. Total laparoscopic excision of retroperitoneal ganglioneuroma using the hanging method and a vessel-sealing device. J Laparoendosc Adv Surg Tech A 2008;18:779-782.

7. Cerullo G, Marrelli D, Rampone B, Miracco C, Caruso S, Di Martino M, et al. Presacral ganglioneuroma: a case report and review of literature. World J Gastroenterol 2007;13:2129-2131.

8. Modha A, Paty P, Bilski MH. Presacral ganglioneuromas. Report of five cases and review of literature. J Neurosurg Spine 2005;2:366-371.

9. Jain M, Shubha BS, Sethi S, Banga V, Bagga D. Retroperitoneal ganglioneuroma: report of a case diagnosed by fine-needle aspiration cytology, with review of the literature. Diagn Cytopathol 1999;21:194-196.

10. Moschovi M, Arvanitis D, Hadjigeorgi C, Mikraki V, Tzortzatou- Stathopoulou F. Late malignant transformation of dormant ganglioneuroma? Med Pediatr Oncol 1997;28:377-381.