CT manifestation of retroperitoneal neuro-ganglionic tumor in children

Objective To describe the CT characterization of retroperitoneal neuroganglionic tumor in order to get a better understanding of the disease. Methods Neuroganglionic tumors proved by operation and pathology (24 cases), as well as bone biopsy (2 cases), were studied in 18 males and 8 females. The mean age of neuroblastoma(14 cases), ganglioneuroblastoma(10 cases), and ganglioneuroma (2 cases) was 1 year 3 months, 3 years 6 months, and 6 years, respectively. Two cases of ganglioneuroma were complicated with leukemia and malignant pheochromocytoma. All cases were examined by CT scanning and 14 of them had contrast enhancement scanning preoperatively. 20 cases were also examined by ultrasound. Results The tumor sizes were 2.0 cm×2.5 cm×2.5 cm～16 cm×10 cm×8 cm. The tumors were all located in the retroperitoneal space, 22 cases were unilateral, 3 were situated in mid line prelumboscrally, and 1 was bilaterally located. The tumor were irregular in 20 cases and round shape in 6 cases; the tumor margin showed distinct in 14 cases and indistinct in 12 cases. Twenty five tumors showed mixture density and isointensity comparing with the kidney, 1 case with homogeneouse low density; 12 of 14 cases were enhanced inhomogeneously and 2 did not enhance; 23 of 26 cases showed different shapes of calcification. Retroperitoneal lymph nodes were swelling in 19 cases. Liver metastases were found in 3 cases, vascular encasement in 18 cases, tumor thrombus in inferior vena cava in 1 case,and tumor extending into spinal canal in 3 cases. Conclusion CT scanning can prompt the diagnosis of retroperitoneal neuroganglionic tumor and bolus injection of contrast medium can further increase the understanding of the abnormality within and around the tumor.