Case report of a ganglioneuroma with metaplasia by adipocytes: use of a multi-disciplinary team as a key aid in difficult diagnosis and combined surgery

Herein, we present a rare case of a dumb-bell ganglioneuroma (GN) with metaplasia by adipocytes that was surgically resected in a 24-year-old woman who was asymptomatic. Because of the difficult diagnosis with no consensus about the location of the tumor, diagnostic and surgical procedures were performed with the assistance of a multi-disciplinary team (MDT) and the use of video-assisted thoracoscopic surgery (VATS). After conventional thoracotomy, histopathological and immunohistochemical examinations revealed that the tumor consisted of spindle cells, ganglion cells, and adipose cells. The histopathological diagnosis was GN with metaplasia by adipocytes. The tumor was resected, and the patient had no postoperative complications during a 3-year follow-up. For tumors whose location cannot be confirmed in the posterior mediastinum or in the retroperitoneum, VATS is an effective confirmatory tool. The recruitment of a MDT can be invaluable for formulating and providing treatment options for the patient.