Pigmented ganglionic tumor of the thorax

Abstract

illillar reported a rare form oL nielan-I otic ganglionic tumor i n a 34-year-old man.T h e specimen was obtained at autopsy froin the left side of the vertebral colunin at the level of the seventh and eighth thoracic vertebrae and consisted of a tumor, 6.0 cm. in diameter, containing a large central black area.T h e tumor infiltrated the ribs, pleura, vertebrae, and contiguous soft structures and involved the sympathetic chain on the leCt, but not the right, side.T h e tumor had nietastasized to the lung, liver, right supiarenal gland, and bones of the base of the skull, but none was found in the choroid and skin.T h e histology of this neoplasm varied markedly.T h e pigmented portions of the tumor showed well-differentiated ganglion cells full 01 melanin, and the nonpigmented tumor was composed of spheroidal and spindle-shaped cells only occasionally containing a few pigment granules.T h e illustrations in the article clearly show pigmented and nonpigniented ganglionic cells and rosettes.Millar thought, unequivocally, that the tumor arose from ganglion cells and that the pigment was melanin.T o support this opinion, he referred to similar ganglionic tumors arising in the suprarenal gland.His case is unique arid approached only by one described by Martiris in 1913 and referred to by Millar.Loretr. in 1570 gave the first description of a nerve-cell tumor in the thoracic syrnpathetic chain.Ganglionic tumors in this area have been described by others under the designation ol ganglioneuroma.I n his book, Pathology of Tumours, Willis9 states in the introduction to the chapter on neuroblastonia and ganglioneuroma, "these nerve-cell tumours are extremely rare (if indeed they ever occur) in the central nervous system, while their most frequent sites of origin are the adrenal gland5 and the ganglia of the sympathetic system."Ewing mentions six cases of ganglion-( ell tumor of the brain reported prior to 1940.Recently we encountered a case similar to the one described by Millar but niuth less