eP679 - Incidental Diagnosis of Presacral Ganglioneuroma in a Female Patient with Oligomenorrhea

Purpose/Background: Ganglioneuroma is an uncommon tumor originating from neural crest tissue of the sympathetic nervous system. The presacral space is an extremely rare location. Patients typically present when the tumor develops a significant size. Here, we report a case of presacral ganglioneuroma diagnosed incidentally in an asymptomatic young female who initially presented with oligomenorrhea for investigations.Methods/Interventions:

Case presentation: A 24-year-old female presented to the hospital complaining of a 6-month history of oligomenorrhea. She did not complain of any pain or discomfort, and no neurologic symptoms were present. The clinical examination was unremarkable.
Abdominopelvic ultrasonography incidentally showed a large heterogeneous pelvic mass with well-defined borders adjacent to the uterus. Magnetic resonance imaging (MRI) of the abdomen and pelvis revealed well-circumscribed presacral mass hypointense on T1 heterogenous hyperintense on T2 with no specific character extending to the extraperitoneal space. This lesion appeared not to originate from surrounding structures.Results/Outcomes: The mass was surgically excised through a transabdominal laparoscopic retroperitoneal approach, and complete tumor resection with free surgical margins was achieved with uneventful postoperative recovery. The histological analysis of the specimen revealed features of ganglioneuroma.Conclusion/

Discussion: Presacral Ganglioneuroma is an extremely rare tumor of sympathetic nerve cells. Despite its usual benign course, ganglioneuroma can suppress other structures while growing, causing pain or irreversible paresis. At present, only twenty-three cases have been reported in the existing literature. This case is the first case to be reported as Presacral Ganglioneuroma in an asymptomatic young female who initially presented with oligomenorrhea excised by minimally invasive surgery.
As radiological investigations have become more widely performed, the number of ganglioneuromas found incidentally has increased. However, it can be difficult to differentiate this lesion preoperatively from other neurogenic tumors with imaging modalities without histopathology examination. The treatment is exclusively surgical, and the prognosis is generally favorable."The gross appearance of the Resected specimen

The gross appearance of the Resected specimen
Laparoscopic intraoperative image shows presacral tumor after partial dissection from adjacent structures

Laparoscopic intraoperative image shows presacral tumor after partial dissection from adjacent structures."