Solitary Polypoid Ganglioneuroma of the Cecum

ABSTRACT

A ganglioneuroma is a very rare neoplasm in the gastrointestinal tract and consists of ganglion cells, nerve fibers, and supporting cells. A gastrointestinal ganglioneuroma is occasionally related to inherited diseases, like neurofibromatosis type I and multiple endocrine neoplasm type 2b. We have experienced a case of a solitary polypoid ganglioneuroma in the cecum of a patient with no history of inherited diseases. The patient was a 56-yr-old male who had suffered from dyspepsia for a year. On the colonoscopic examination, a sessile polyp, measuring 0.7 x 0.7 cm in greatest dimensions, was discovered and eliminated. The remaining large intestine was unremarkable. Microscopically, the polyp was composed of isolated or nested ganglion cells admixed with a proliferation of spindle cells in the mucosa and the submucosa. The background showed interspersed cystic glands in an expanded lamina propria. Immunohistochemically, the ganglion cells were positive for NSE and NeuN while the spindle cells demonstrated a positive response to S-100 protein. Since a ganglioneuroma has a benign nature, complete resection is the treatment of choice.