Open Access Case report

Novel use of a Weerda laryngoscope for transoral excision of a cervical ganglioneuroma: a case report

Hidenori Yokoi1,2*, Atsushi Arakawa3, Ayako Inoshita1 and Katsuhisa Ikeda1

Author Affiliations

1 Departments of Otolaryngology Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan

2 Departments of Otolaryngology Head and Neck Surgery, Kyorin University School of Medicine

3 Departments of Pathology, Juntendo University School of Medicine, Tokyo, Japan

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Journal of Medical Case Reports 2012, 6:88 doi:10.1186/1752-1947-6-88

Published: 26 March 2012

Abstract

Introduction

A ganglioneuroma is a benign neoplasm arising from neural crest cells of the sympathetic nerve fibers and is most commonly seen in the posterior mediastinum or retroperitoneum. Although very uncommon, ganglioneuromas must be included in the differential diagnosis of neck masses. In young adult women, neck incisions made for excision of these benign tumors should be avoided whenever possible.

Case presentation

We herein describe the case of a 19-year-old Japanese woman with a ganglioneuroma. The tumor was found in the parapharyngeal space, an unusual location. A fine-needle aspiration biopsy was performed but was considered inadequate to make a definitive diagnosis, so the asymptomatic lesion was surgically excised using a Weerda laryngoscope. The lesion measured 4 × 3 cm in size and was encapsulated. A pathological analysis showed the presence of two distinct cell types, ganglion cells and Schwann cells, embedded in a loose myxoid stroma. The final diagnosis was a ganglioneuroma.

Conclusion

A complete excision was made possible by using a transoral approach with a novel use of the Weerda laryngoscope. Although its applicability to specific cases depends on the location, size and nature of the tumor, we believe that the Weerda laryngoscope will continue to be useful for performing transoral surgery for cervical tumors.