C0143 - Colonic Ganglioneuroma: A Rare Finding During Colonoscopy

Samarth Sharma, ¹, Jason Nolan, MD^2
1University of Alabama, Nashville, TN; ²Vanderbilt Wilson County Hospital, Cookeville, TN

Introduction: Gastrointestinal ganglioneuromas are rare and benign hamartomatous tumors that originate from the autonomic nervous system.

Case Description/Methods: A 45-year-old female presented to our clinic with a recent diagnosis of diverticulitis. The patient recovered from her diverticulitis and was scheduled for a colonoscopy to follow up on her diverticulitis. During the colonoscopy, the patient was found to have a large polyp measuring around 15mm in the transverse colon which was excised by hot snare polypectomy (Figure 1). Pathology from the polyp showed it to be a ganglioneuroma of the colon (Figure 2)

Discussion: Ganglioneuromas are benign tumors of undifferentiated neural crest cells and are uncommon worldwide and can occur at any autonomic location. Ganglioneuromas normally have a predilection for the head, neck, and or adrenal glands. Endoscopically, intestinal ganglioneuromas have no discerning phenotypic characteristics which can distinguish them from other types of colon polyps. They are definitively diagnosed by biopsy followed by histology, which demonstrates immunoreactivity to S100 with comma-shaped nuclei mixed with aggregates of ganglion cells (Figure 3). Gastrointestinal ganglioneuromas are usually treated endoscopically and completely excised. Currently, no guideline exists on the management of solitary ganglioneuromas or recommendations for surveillance colonoscopy. However, most authors agree that repeat colonoscopy is not necessary due to the benign nature of the lesion, which tends not to recur.


In conclusion, gastrointestinal ganglioneuromas are rare and benign hamartomatous tumors that originate from the autonomic nervous system. They are generally not associated with any systemic or genetic conditions and tend not to recur. As a result, they can be safely excised endoscopically without complications.





Disclosures:


Samarth Sharma, ¹, Jason Nolan, MD². C0143 - Colonic Ganglioneuroma: A Rare Finding During Colonoscopy, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.