Cutaneous ganglioneuromas: a case report and review of the literature.

The occurrence of ganglioneuromas outside the sympathetic chains of the mediastinum and abdomen in the nonpediatric age group is rare. We report the case of a solitary cutaneous ganglioneuroma on the abdomen of a 52-year-old woman. The lesion, which had been present for 20 years, measured 1.2 cm in greatest dimension. Unmyelinated axons, Schwann cells, and scattered mature ganglion cells were identified by histochemistry, immunohistochemistry, and electron microscopy. Only three similar cases have been reported in the literature to date. Ganglioneuromas have also been reported as mature components of metastatic neuroblastomas and in association with plexiform neurofibromas, neither of which was present in this case. The pathogenesis of this lesion is unclear, however, aberrant migration of neural crest elements is the most likely explanation. The possible trophic role of sex steroids is also discussed. Although no follow-up series exist, local excision should he curative considering the small size and histologically benign appearance of the lesion.