A case of ganglioneuroma of the colon during routine colonoscopy

Introduction: Colonic ganglioneuromas are classified as hamartomatous polyps that are composed of ganglion cells, nerve fibers, and enteric nervous system cells. The GNs of the gastrointestinal tract can be classified into three groups based on the size and the number of polyps: polypoid GN, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis. Polypoid GNs, seen in patients with Cowden’s syndrome, are small, sessile or pedunculated polyps that have a similar appearance to hyperplastic and adenomatous polyps. Ganglioneuromatous polyposis, seen most commonly in patients with MEN IIB, NF1, Cowden’s syndrome, usually manifests as more than 20 sessile or pedunculated polyps. Lastly, diffuse ganglioneuromatosis, seen in MEN IIB7 and NF1, involves proliferation of neuronal cells in the entire colon, but does not extend into the ileum. Case Report: A 57-year-old African-American male with a history of untreated chronic hepatitis C cirrhosis with viral load of over 4 million copies, seizure disorder, mild mental retardation, hypothyroidism, hypertension, diabetes mellitus type 2, presented to the gastroenterology clinic for scheduling of a screening colonoscopy. At that time, he was completely asymptomatic. On colonoscopy, one 4 mm sessile polyp was resected in the sigmoid colon and was histologically diagnosed as a ganglioneuroma (GN). Conclusion: The finding of an asymptomatic, solitary GN in our patient does not warrant more frequent colon cancer screening given its benign nature. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 6 No. 9, September 2015. ISSN – [0976-3198] Int J Case Rep Images 2015;6(9):560–563. www.ijcasereportsandimages.com Herman et al. 560 CASE REPORT OPEN ACCESS A case of ganglioneuroma of the colon during routine colonoscopy Michael Herman, Jean Abed, Wenjing Shi, Arzu Buyuk, Pavan Kumar Mankal, Donald Kotler, Gabriel Ionescu