Case Report: Mediastinal Ganglioneuroma Presented as Chronic Diarrhea in a Young Saudi Girl


Ganglioneuromas (GN) are rare, benign neurogenic tumors that arise from sympathetic ganglia. They are often asymptomatic. However, in rare cases, they may secrete catecholamines, vasoactive intestinal polypeptides (VIP), or androgenic hormones and manifest with flushing, symptoms of catecholamine excess or chronic diarrhea. We report a young Saudi girl with chronic secretory diarrhea, severe hypokalemia and abdominal distension. After an extensive work up, a well-defined hypodense heterogeneous mediastinal mass was noted in radio imaging. A complete recovery was seen after surgical removal of that mediastinal mass which turned to be a ganglioneuroma.

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Alqoaer, K. , Albalawi, M. , Alnoaiji, M. and Khan, A. (2014) Case Report: Mediastinal Ganglioneuroma Presented as Chronic Diarrhea in a Young Saudi Girl. International Journal of Clinical Medicine, 5, 420-424. doi: 10.4236/ijcm.2014.57057.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Guarino, A. and De Marco, G. (2004) Persistent Diarrhea. In: Walker, W.A., Ed., Text Book of Pediatric Gastrointestinal Disease, 4th Edition, BC Decker Inc., 180-193.
[2] Rha, S.E., Byun, J.Y., Jung, S.E., Chun, H.J., Lee, H.G. and Lee, J.M. (2003) Neurogenic Tumors in the Abdomen: Tumor Types and Imaging Characteristics. Radio Graphics, 23, 29-43.
[3] Lonergan, G.J., Schwab, C.M., Suarez, E.S. and Carlson, C.L. (2002) From the Archives of the AFIP Neuroblastoma, Ganglioneuroblastoma, and Ganglioneuroma: Radiologic-Pathologic Correlation. Radio Graphics, 22, 911-934.
[4] Geoerger, B., Hero, B., Harms, D., Grebe, J., Scheidhauer, K. and Berthold, F. (2001) Metabolic Activity and Clinical Features of Primary Ganglioneuromas. Cancer, 91, 1905-1913.<1905::AID-CNCR1213>3.0.CO;2-4
[5] Hawfield, H.H. and Daisley Jr., G.W. (1952) A Report of a Case of a Functional Adrenal Ganglioneuroma. Clinical Proceedings Children’s Hospital of the District of Columbia, 8, 98-105.
[6] Verner, J.V. and Morrison, A.B. (1958) Islet Cell Tumor and a Syndrome of Refractory Watery Diarrhea and Hypokalemia. American Journal of Medicine, 25, 374-380.
[7] Said, S.I. and Mutt, V. (1970) Potent Peripheral and Splanchnic Vasodilator Peptide from Normal Gut. Nature, 225, 863-864.
[8] Bloom, S.R., Polak, J.M. and Pearse, A.G. (1973) Vasoactive Intestinal Peptide and Watery-Diarrhoea Syndrome. Lancet, 2, 14-16.
[9] Swift, P.G., Bloom, S.R. and Harris, F. (1975) Watery Diarrhoea and Ganglioneuroma with Secretion of Vasoactive Intestinal Peptide. Archives of Disease in Childhood, 50, 896-899.
[10] Iida, Y., Nose, O., Kai, H., Okada, A., Mori, T., Lee, P.K., Kakudo, K. and Yanaihara, N. (1980) Watery Diarrhoea with a Vasoactive Intestinal Peptide-Producing Ganglioneuroblastoma. Archives of Disease in Childhood, 55, 929-936.
[11] Long, R.G., Bryant, M.G., Mitchell, S.J., Adrian, T.E., Polak, J.M. and Bloom, S.R. (1981) Clinicopathological Study of Pancreatic and Ganglioneuroblastoma Tumours Secreting Vasoactive Intestinal Polypeptide (Vipomas). British Medical Journal (Clinical Research Ed.), 282, 1767-1771.
[12] Socha, J., Dobrzańska, A., Rowecka, K., Cichy, W., Bierla, J., Stodulski, J., et al. (1984) Chronic Diarrhea Due to VIPoma in Two Children. Journal of Pediatric Gastroenterology and Nutrition, 3, 143-148.
[13] Murphy, M.S., Sibal, A. and Mann, J.R. (2000) Persistent Diarrhoea and Occult Vipomas in Children. BMJ, 320, 1524-1526.
[14] Zhang, W.Q., Liu, J.F., Zhao, J., Zhao, S.Y. and Xue, Y. (2009) Tumor with Watery Diarrhoea, Hypokalaemia in a 3-Year-Old Girl. European Journal of Pediatrics, 168, 859-862.
[15] Leleiko, N.S., Gee, M.S. and Sadow, P.M. (2010) An 18.5-Month-Old Girl with Watery Diarrhea and Poor Weight Gain. New England Journal of Medicine, 362, 1619-1626.

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