Title : Case 622 |
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Age / Sex : 41 / M Chief complaint : Right arm pain and right hand numbness DiscussionAnswer: Ganglioneuroma
Findings: CT: About 2.5cm sized, ill-defined, subtle high density lesion(compared with spinal cord) at Rt. formen of C5/6 with spinal cord compression
MR: About 2.5cm sized, dumbbell shaped, high SI lesion on T2W1 and low SI on T1WI with subtle rim enhancement at intradural extramedullary and extradural space of Rt. side of C4/5 - with spinal cord compression
Differential Diagnosis: schwannoma, neurofibroma, meningioma (lymphomas, soft-tissue sarcomas, Ewing’s sarcoma, chondrosarcomas, and bone metastases à involve, invade and erode bones)
Diagnosis: Ganglioneuroma
Discussion: - Rare benign tumours - Ganglia of the sympathetic system - Most common location ð retroperitoneum and posterior mediastinum - Cervical nerve root within the intervertebral foramen ð extremely uncommon - Ganglioneuroma dumbbell tumor ð 0.8 to 3.5% - Associations demonstrated with Neurofibromatosis type 1 (NF-1) - occur more frequently in children or young adults ð recent study (mean age) ☞ around 40 to 50 years old - Prognosis ð generally favorable ☞ but, local recurrence, regional lymph node metastasis ☞ transformation into malignant peripheral nerve sheath tumors - CT ð Low internal attenuation relative to skeletal muscle (abundant myxoid matrix), 20% may show calcification - MRI ð Homogeneous intermediate signal intensity on all sequences ð occasional whorled appearance of low signal intensity on T1 and T2
References:
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Correct Answer | |||
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Total applicants | 22 | Correct answers | 1 |
Name | Institution | ||
김기욱 | 국군대전병원, 전문의 | ||
Semi-Correct Answer | |||
Total applicants | 22 | Semi-Correct answers | 16 |
강지희 | 서울대학교병원, 전문의 | ||
김동언 | 전공의 | ||
이준영 | 전공의 | ||
조은경 | 새움병원, 전문의 | ||
윤유성 | 순천향대 부천병원, 전문의 | ||
손상욱 | 군의관, 전문의 | ||
한진우 | 전공의 | ||
김유진 | 전문의 | ||
신재환 | 국군춘천병원, 전문의 | ||
장성원 | 중앙보훈병원, 전공의 | ||
한유비 | 병무청, 전문의 | ||
최형인 | 국군수도병원, 전문의 | ||
김보람 | 전문의 | ||
김형민 | 전문의 | ||
김동수 | 전공의 | ||
박병진 | 국군강릉병원, 전문의 |
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