Retroperitoneal ganglioneuroma presenting as lower back pain.

Retroperitoneal ganglioneuroma (RGN) is a rare benign tumor that arises from the retroperitoneal sympathetic ganglia composed of mature Schwann cells, ganglion cells and nerve fibers. These tumors can occur anywhere along the paravertebral sympathetic plexus and occasionally from adrenal medulla. Although they grow in excessive size, they may cause compression to adjacent organ or structures thus giving rise to symptoms. Resecting RGN's is a challenging endeavor, as they tend to encase neighboring vessels to their site of origin. The reported case is a 43-year-old male who presented with lumbar pain that increased progressively in intensity over the last 6 months. Preoperative investigations revealed a large tumor with encasement of the origins of the superior mesenteric artery and bilateral renal arteries. The tumor was completely resected and the final pathology confirmed the diagnosis of RGN.

Adrenal gland injury after blunt abdominal trauma: Two case series and review of the literature.

INTRODUCTION: Adrenal gland injury (AGI) is a rare form of trauma that is often misdiagnosed, especially if isolated. PRESENTATION OF CASE: Herein we describe two rare cases of adrenal hematoma (AH) and adrenal contusion due to blunt abdominal trauma. A 33-year-old Caucasian male who was transported to the emergency department after a low-speed motorbike accident and a 69-year old Caucasian female who fell from 50 cm height. Both where complaining of intense pain in the right flank. Neither were under anti-coagulant or anti-platelet therapy. In both patients thoracoabdominal CE-CT revealed the injury. DISCUSSION: AGI is an uncommon finding in blunt trauma and isolated adrenal injuries usually result from low force accidents. Treatment is most commonly conservative, but depends on patient's status. In Greece, to our knowledge, these are the first such cases reported in adults. CONCLUSION: Diagnosis needs high level of clinical suspicion.