A case of giant retroperitoneal ganglioneuroma encasing major vascular structures

Ganglioneuroma (GN) is a rare benign tumor arising from sympathetic ganglion cells, often located in the retroperitoneum. We report a case of a 33-year-old woman presenting with intermittent low back pain for 2 months. Imaging revealed a large retroperitoneal mass (24 × 36 × 68 mm) encasing the inferior vena cava (IVC) and right renal vein, with a high suspicion for GN or lymphangioma. Surgical exploration via laparotomy confirmed a tough, adherent mass (5 × 8 × 10 cm) intimately associated with the IVC and renal vessels. Complete resection with vascular repair was performed. Pathology confirmed mature ganglion cells positive for SOX10 and S100, consistent with GN. The patient recovered uneventfully and remained well at 4-month follow-up.