Synchronous ganglioneuroma and schwannoma of the vagal inferior ganglion

Neurogenic neoplasms resulting from autonomic nerves are considerably rare. In this paper, we report a case of a 41-year-old woman with composite tumor of synchronous ganglioneuroma and schwannoma in the vagal inferior ganglion. Ultrasonography and computed tomography showed a well-defined mass, which extruded from the internal and external carotid arteries. Two tumors were closely attached but with an evident boundary. The small tumor was composed of spindle cells and numerous mature ganglion cells, and the large one consisted entirely of differentiated neoplastic Schwann cells. Results showed that these tumors were a schwannoma arising in a ganglioneuroma of the vagal inferior ganglion. Our case is the first to demonstrate the occurrence of schwannoma in benign ganglioneuroma. We also provided clinical and pathological evidence that such transformation can occur spontaneously.