Ganglioneuroma Presenting as Presacral Mass: Surgical Management of a Rare Tumor—A Case Report

Presacral ganglioneuroma is an extremely rare and benign tumor of neural crest origin. To the best of our knowledge, less than 30 cases have been reported in adult population. The goal of this case report is to draw the medical community attention to an unusual diagnosis and we emphasize clinical features, imagiological findings, and surgical management of this rare entity. We report a case of a presacral ganglioneuroma, 5.2 × 5.6 × 6.7 cm in size, which was found in a young woman with suprapubic pain and amenorrhea. Complete tumor resection was achieved using the Kraske technique. The patient had an uneventful recovery. Presacral tumors are rare in adults. A magnetic resonance imaging is the radiological investigation method of choice. Preoperative biopsy is controversial. Surgery is the primary means of diagnosis and treatment and is always recommended. Three approaches are described: abdominal, posterior (Kraske), and combined. The choice of technique depends on the size of the tumor, the location relative to S3, and the extent of adjacent structures. The prognosis is generally favorable.