1041 Recurrent Retropharyngeal Ganglioneuroma in a Pediatric Patient

Abstract Introduction Ganglioneuroma is a rare benign subtype of peripheral neuroblastic tumor that arises from sympathetic ganglion cells. Fewer than 10% these cases occur in the head and neck are rarely seen pediatric patients. Clinical symptoms treatment dependent on mass location extension. The authors present case recurrent retropharyngeal ganglioneuroma patient. Report case(s) Patient 2-year-old previously healthy female who presented with progressive snoring found to have lymphadenopathy during tonsillectomy. Differential diagnosis included abscess; however, after no improvement antibiotics, malignancy was suspected. Pathology results needle biopsy confirmed ganglioneuroma. CT imaging showed extension bilateral retropharyngeal, posterior mediastinal paraspinal, retroperitoneal spaces. Given concerns for significant morbidity complete resection, patient underwent partial resection mass, followed by chemotherapy decrease burden. initially did well, then developed nine-month snoring, positional apnea, persistent stertor, dysphagia. Sleep study severe obstructive sleep apnea (OSA) hypopnea index (AHI) 74, oxygen nadir 66%, maximum transcutaneous carbon dioxide (CO2) level 58 mmHg. Repeat regrowth large right-sided effect right oropharynx associated vasculature, moderate narrowing airway. Supplemental via nasal cannula initiated as inpatient, due noninvasive positive pressure support would further compromise critical Urgent repeat debulking pharyngectomy completed. Post-operatively, patient's dependence, resolved within 24 hours. considerable mild OSA, AHI 1.4, 89%, CO2 47 Her dysphagia residual intermittent improving signs recurrence mass. Conclusion Upper airway obstruction secondary patients even less commonly be This offers understanding complexities diagnosing treating insidiously growing tumors prompt management critically obstructed airways. Support (if any)