Could Retroperitoneal Ganglioneuroma be a Dopamine Secreting Ganglioneuroma?

Ganglioneuromas are rarely occurring benign tumors characterized by hyperplasia of mature ganglia and satellite cells. They are well-differentiated, slow growing, and autonomous nervous system neoplasms, which are usually asymptomatic and do not release any hormones. A male patient aged 26 years was evaluated for secondary hypertension six months ago. Ultrasonography of the abdomen revealed a mass lesion around the right kidney. An analysis of the 24-hour urine sample of the patient revealed the following parameters: 5-HIAA=3.9 mg/day (2-7), metanephrine=56.3 mu g/day (52-341), and normetanephrine=146.1 mu g/day (88-444). The computed tomography scan of the abdomen showed a retroperitoneal mass of 10 cm in size, containing minute calcified foci in the right retroperitoneal region. The mass was excised through general surgery and was classified as ganglioneuroma. The blood pressure of the patient returned to normal level after surgery, and he needed no further antihypertensive treatment. Besides, the metanephrine and normetanephrine levels in the 24-hour urine were also observed to be normal as in the preoperative period. Retroperitoneal masses can actually be ganglioneuromas and an accurate diagnosis can be achieved only through postoperative histopathological evaluation. After the operation, blood pressure of the patient returned to normal. This suggests that retroperitoneal ganglioneuroma could possibly secrete dopamine, epinephrine, or norepinephrine.