Complete resection of an incidentally discovered posterior mediastinal ganglioneuroma in an asymptomatic child: a case report.

Ganglioneuromas (GNs) are rare, benign tumors originating from sympathetic ganglia, typically discovered in symptomatic children due to compressive effects. We report an unusual case of an 8-year-old girl with a large posterior mediastinal GN, incidentally discovered on chest X-ray during a routine evaluation. Computed tomography imaging revealed a well-defined, 11 × 7 × 5 cm homogeneous mass extending from the aortic arch to the T10 vertebral level, adherent to the descending aorta and vertebrae. A left posterolateral thoracotomy was performed for complete excision without complications. Histopathology confirmed mature GN. The patient had an uneventful recovery and remains asymptomatic on follow-up. This case highlights the importance of thorough evaluation of incidental mediastinal findings and emphasizes surgical expertise in resecting large, adherent masses safely. It also underscores the potential for asymptomatic presentation even in sizable tumors, a rare occurrence in pediatric patients.