Cervical Ganglioneuroma in a 3-Year-Old Child: A Case Report

Abstract

Background: Ganglioneuroma is a rare benign neuroblastic tumour arising from mature ganglion cells of the sympathetic nervous system. Cervical involvement is uncommon, particularly in very young children, and may be difficult to recognise preoperatively because of its slow growth and non-specific clinical and radiological features. Case presentation: A 3-year-old boy receiving oral iron supplementation for iron-deficiency anaemia presented with a progressively enlarging right submandibular mass of 6 months’ duration, without dysphagia, dysphonia, dyspnoea, or other compressive symptoms. Cervical CT angiography demonstrated a well-defined 45 × 26 × 52 mm soft-tissue mass with moderate heterogeneous enhancement. The lesion displaced the carotid vessels laterally, partially encased the right internal carotid artery while preserving the intervening fat plane, and compressed the pharyngeal lumen without evidence of vascular invasion or bone involvement. Complete excision was performed through a Paul André cervicotomy. Ligation of the external carotid artery was required to improve surgical exposure, while the internal carotid artery and vagus nerve were preserved. Histopathological examination showed mature ganglion cells within a Schwann-cell-rich stroma, confirming a mature ganglioneuroma arising from the cervical sympathetic chain. The postoperative course was uneventful, with no Horner’s syndrome, and the child remained disease-free during follow-up. Conclusion: Cervical ganglioneuroma should be considered in the differential diagnosis of a slowly enlarging lateral neck mass in children. Histopathological examination establishes the diagnosis, and complete surgical excision is associated with a favourable outcome.