Abstract
The case involved a 36-year-old woman who had undergone cesarian section 10 years earlier when an 8-cm diameter myoma of the uterus was pointed out. In about September 2008, she began to feel something wrong at the right buttock and developed numbness of the lower limbs, and she was referred to our hospital in April 2009. Abdominal CT scan showed a 13-cm diameter well-demarcated tumor at the anterior aspect of the sacrum, which had encircled about two-to-third of the circumference of the coccyx. A biopsy of the tumor was done from the side of the coccyx and ganglioneuroma was diagnosed. Though it was a benign tumor pathologically, surgery was performed in August 2009, because it had been increasing, symptoms appeared, a possibility of malignancy could not be ruled out only by biopsy findings, and there were some reports on malignant change of ganglioneuroma. At surgery, the anterior surface of the tumor was loosely adherent to the surrounding organs so that the intestine could be preserved. The back surface of the tumor was hard where was suggestive of tumor invasion. Associated resection of the forth sacrum and below was thus performed. The resected specimen was a 13 × 9 × 7.5 cm solid tumor covered with a capsule. The histopathological diagnosis was matured type ganglioneuroma with parts showing disappearance of bone parenchyma and progression to the bone marrow.
