A Rare Incidental Finding of Appendiceal Ganglioneuroma During Screening Colonoscopy

Ganglioneuromas are rare, benign tumors of the autonomic nervous system that arise from neural crest cells. They most commonly occur in the adrenal glands, posterior mediastinum, and retroperitoneum, with gastrointestinal (GI) involvement being particularly uncommon. Colonic ganglioneuromas are typically asymptomatic, and thus are often discovered incidentally during routine screening colonoscopies. However, depending on their size, location, and extent, they may present with nonspecific GI symptoms. Herein, we present a case of a 52-year-old male with a history appendectomy who was incidentally found to have a benign submucosal ganglioneuroma at the appendiceal orifice during his first colorectal cancer screening. The lesion was successfully removed using a hot snare polypectomy without complications. Our patient was recommended for a follow-up colonoscopy in 5 years given the absence of adenomatous tissue and the lack of established management guidelines. This case highlights the importance of considering ganglioneuroma in the differential diagnosis of submucosal lesions, even when endoscopic appearance suggests a benign polyp.