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Isolated Colonic Polypoid Ganglioneuroma

  • Amer A. Alkhatib and Chaney Tamara
Published/Copyright: May 1, 2013
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 113 Issue 5

A man with gastric cancer presented with a 3-month history of constipation and abdominal pain. Colonoscopy revealed a 9-mm pedunculated polyp in the sigmoid colon (image A), which was then removed. Histopathologic evaluation of the resected polyp (image B) revealed displaced colonic crypts with underlying proliferation of ganglion (white arrows) and spindled Schwann cells (black arrows) within the lamina propria. Furthermore, the polyp reacted positively to neuron-specific enolase stain and S-100 stain. Although the patient's symptoms did not resolve after polypectomy, his constipation and abdominal pain improved with laxatives and narcotics, respectively. The patient was diagnosed as having colonic polypoid ganglioneuroma and continues to receive chemotherapy.

Intestinal ganglioneuroma, a rare type of hereditary hamartomatous polyp, is characterized by benign proliferation of nerve ganglion cells, nerve fibers, and supporting cells of the enteric nervous system.1,2 Intestinal ganglioneuromas can be found in patients with familial adenomatosis coli, tuberous sclerosis, Cowden disease, juvenile polyposis, von Recklinghausen disease, and multiple endocrine neoplasia type 2.2,3

Colonic polypoid ganglioneuroma, a type of intestinal ganglioneuroma, is usually discovered during routine endoscopy, surgery, or autopsy as a benign solitary polyp with no established risk of malignancy. It may present with abdominal pain, obstruction, constipation, ileus, appendicitis, and weight loss.1-3

From Cancer Treatment Centers of America in Tulsa, Oklahoma
Address correspondence to Amer A. Alkhatib, MD, Division of Gastroenterology, Cancer Treatment Centers of America, 10109 E 79th St, Tulsa, OK 74133-4564. E-mail:

  1. Financial Disclosures: None reported.

References

1 Chan OT Haghighi P . Hamartomatous polyps of the colon: ganglioneuromatous, stromal, and lipomatous. Arch Pathol Lab Med.2006.130(10):1561-1566.10.5858/2006-130-1561-HPOTCGSearch in Google Scholar PubMed

2 Shekitka KM Sobin LH . Ganglioneuromas of the gastrointestinal tract: relation to Von Recklinghausen disease and other multiple tumor syndromes. Am J Surg Pathol.1994;18(3):250-257.10.1097/00000478-199403000-00004Search in Google Scholar

3 Mendez IM Pereda T Rodriguez FJ Funez R Sanchez A . Solitary colonic polypoid ganglioneuroma. Diagn Pathol.2008;3:20. doi:10.1186/1746-1596-3-20.10.1186/1746-1596-3-20Search in Google Scholar PubMed PubMed Central

Received: 2012-10-04
Revised: 2012-12-04
Accepted: 2012-12-10
Published Online: 2013-05-01
Published in Print: 2013-05-01

© 2013 The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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  2. He Walked With Confidence Into the Wilderness of Life: A Tribute to Philip E. Greenman, DO (1928-2013)
  3. AOA Communication
  4. OFFICIAL CALL
  5. Proposed Amendment to the AOA Constitution
  6. Original Contribution
  7. The Effect of Osteopathic Manipulative Treatment on Postoperative Medical and Functional Recovery of Coronary Artery Bypass Graft Patients
  8. Use of the SMART Balance Master to Quantify the Effects of Osteopathic Manipulative Treatment in Patients With Dizziness
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  11. Metastatic Brain Tumors: Current Therapeutic Options and Historical Perspective
  12. Special Communication
  13. Enhancing Your Manuscript With Graphic Elements, Part 2: Figures
  14. Clinical Images
  15. Isolated Colonic Polypoid Ganglioneuroma
  16. In Your Words
  17. Seeing With Native Eyes
  18. CME Quiz
  19. CME Quiz
https://doi.org/10.7556/jaoa.2013.113.5.433
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. Editorial
  2. He Walked With Confidence Into the Wilderness of Life: A Tribute to Philip E. Greenman, DO (1928-2013)
  3. AOA Communication
  4. OFFICIAL CALL
  5. Proposed Amendment to the AOA Constitution
  6. Original Contribution
  7. The Effect of Osteopathic Manipulative Treatment on Postoperative Medical and Functional Recovery of Coronary Artery Bypass Graft Patients
  8. Use of the SMART Balance Master to Quantify the Effects of Osteopathic Manipulative Treatment in Patients With Dizziness
  9. Review
  10. An Osteopathic Approach to Gastrointestinal Disease: Somatic Clues for Diagnosis and Clinical Challenges Associated With Helicobacter pylori Antibiotic Resistance
  11. Metastatic Brain Tumors: Current Therapeutic Options and Historical Perspective
  12. Special Communication
  13. Enhancing Your Manuscript With Graphic Elements, Part 2: Figures
  14. Clinical Images
  15. Isolated Colonic Polypoid Ganglioneuroma
  16. In Your Words
  17. Seeing With Native Eyes
  18. CME Quiz
  19. CME Quiz
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