Pediatric Hematology/Oncology and ImmunopathologyPediatric Hematology/Oncology and ImmunopathologyВопросы гематологии/онкологии и иммунопатологии в педиатрии1726-17082414-9314Fund Doctors, Innovations, Science for Children42910.24287/1726-1708-2020-19-4-133-142CLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯGanglioneuroma as the phenomenon of neuroblastoma maturationГанглионейрома как феномен дозревания нейробластомыhttps://orcid.org/0000-0002-3864-7403BabakhanovaS. B.БабахановаС. Б.
Russian Federation

Sevil B. Babakhanova, Pediatric Oncology Resident

1 Samory Mashela St., Moscow 117997

Бабаханова Севиль Бабахановна, ординатор 2-го года обучения по специальности «детская онкология»

117997, Москва, ул. Саморы Машела, 1

dr.sevil@yandex.ruhttps://orcid.org/0000-0002-3704-8783KachanovD. Yu.КачановД. Ю.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0001-8129-0545ShcherbakovA. P.ЩербаковА. П.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-9375-7517RoshchinV. Yu.РощинВ. Ю.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0003-1308-8622DruyA. E.ДруйА. Е.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-6158-2222LikarYu. N.ЛикарьЮ. Н.
Russian Federation

Moscow

Москва

https://orcid.org/0000-0002-3767-4477ShamanskayaT. V.ШаманскаяТ. В.
Russian Federation

Moscow

Москва

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian FederationФГБУ «Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии им. Дмитрия Рогачева» Минздрава России081220201941331422112202021122020Copyright ©; 2025, «D. Rogachev NMRCPHOI»Copyright ©; 2025, ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России2025«D. Rogachev NMRCPHOI»ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава Россииhttps://creativecommons.org/licenses/by/4.0https://hemoncim.com/jour/article/view/429

Ganglioneuroma (GN) represents a mature, well-differentiated tumor arising from the sympathetic nervous system. Mostly developing de novo, GN can appear during the treatment course of poorly differentiated or undifferentiated tumors of the sympathetic nervous system, such as neuroblastoma, or as a result of their spontaneous maturation. In this article we report three clinical cases of spontaneous and induced maturation of neuroblastoma (primary tumor and metastatic lesion) to GN. Histological verification of long-lasting stable or progressing residual tumor mases in patients with neuroblastoma stratified to the observation group plays a pivotal role as it may significantly affect the treatment course. The patients' parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

Ганглионейрома (ГН) является зрелой, дифференцированной опухолью периферической нервной системы. Большинство ГН развиваются de novo, но часть новообразований может появляться в процессе лечения низкодифференцированных или недифференцированных опухолей периферической нервной системы (нейробластома) или в результате их спонтанного созревания. В статье представлено описание 3 клинических случаев спонтанного и индуцированного созревания нейробластомы (первичной опухоли и метастатического очага) до ГН. Представленные данные подчеркивают важность гистологической верификации длительно сохраняющихся или увеличивающихся в размерах очагов у пациентов с нейробластомой группы наблюдения, что критически может повлиять на тактику их дальнейшего ведения. Родители дали согласие на использование информации, в том числе фотографий детей, в научных исследованиях и публикациях.

neuroblastomaganglioneuromachildrenTrkнейробластомаганглионейромадетиTrk1. Johnsen J.I., Dyberg C., Wickström M. Neuroblastoma – A Neural Crest Derived Embryonal Malignancy. Front Mol Neurosci 2019; 12 (9): 1–11. DOI: 10.3389/fnmol.2019.00009Johnsen J.I., Dyberg C., Wickström M. Neuroblastoma – A Neural Crest Derived Embryonal Malignancy. Front Mol Neurosci 2019; 12 (9): 1–11. DOI: 10.3389/fnmol.2019.000092. Cecchetto G., Mosseri V., De Bernardi B., Helardot P., Monclair T., Costa E., et al. Surgical risk factors in primary surgery for localized neuroblastoma: the LNESG1 study of the European International Society of Pediatric Oncology Neuroblastoma Group. J Clin Oncol 2005; 23 (33): 8483– 9. DOI: 10.1200/JCO.2005.02.4661Cecchetto G., Mosseri V., De Bernardi B., Helardot P., Monclair T., Costa E., et al. Surgical risk factors in primary surgery for localized neuroblastoma: the LNESG1 study of the European International Society of Pediatric Oncology Neuroblastoma Group. J Clin Oncol 2005; 23 (33): 8483– 9. DOI: 10.1200/JCO.2005.02.46613. Терновая Е.С., Качанов Д.Ю., Шаманская Т.В., Щербаков А.П., Варфоломеева С.Р., Рубцова Н.А. Факторы риска по данным визуализации у пациентов с нейробластомой. Обзор литературы. Российский журнал детской гематологии и онкологии 2019; 6 (3): 31–43.Терновая Е.С., Качанов Д.Ю., Шаманская Т.В., Щербаков А.П., Варфоломеева С.Р., Рубцова Н.А. Факторы риска по данным визуализации у пациентов с нейробластомой. Обзор литературы. Российский журнал детской гематологии и онкологии 2019; 6 (3): 31–43.4. Shimada H., Ambros I.M., Dehner L.P., Hata, J., Joshi V.V., Roald B., et al. The International Neuroblastoma Pathology Classification (the Shimada system). Cancer 1999; 86 (2): 364–72. DOI: 10.1002/(sici)1097-0142(19990715)86:2<364::aid-cncr21>3.0.co;2-7Shimada H., Ambros I.M., Dehner L.P., Hata, J., Joshi V.V., Roald B., et al. The International Neuroblastoma Pathology Classification (the Shimada system). Cancer 1999; 86 (2): 364–72. DOI: 10.1002/(sici)1097-0142(19990715)86:2<364::aid-cncr21>3.0.co;2-75. Shimada H., Umehara S., Monobe Y., Hachitanda Y., Nakagawa A., Goto S., et al. International neuroblastoma pathology classification for prognostic evaluation of patients with peripheral neuroblastic tumors. Cancer 2001; 92 (9): 2451–61. DOI: 10.1002/1097-0142(20011101)92:9<2451::aid-cncr1595>3.0.co;2-sShimada H., Umehara S., Monobe Y., Hachitanda Y., Nakagawa A., Goto S., et al. International neuroblastoma pathology classification for prognostic evaluation of patients with peripheral neuroblastic tumors. Cancer 2001; 92 (9): 2451–61. DOI: 10.1002/1097-0142(20011101)92:9<2451::aid-cncr1595>3.0.co;2-s6. Okamatsu C., London W.B., Naranjo A., Hogarty M.D., Gastier-Foster J. M., Look A.T., et al. Clinicopathological characteristics of ganglioneuroma and ganglioneuroblastoma: A report from the CCG and COG. Pediatric Blood Cancer 2009; 53 (4): 563–9. DOI: 10.1002/pbc.22106Okamatsu C., London W.B., Naranjo A., Hogarty M.D., Gastier-Foster J. M., Look A.T., et al. Clinicopathological characteristics of ganglioneuroma and ganglioneuroblastoma: A report from the CCG and COG. Pediatric Blood Cancer 2009; 53 (4): 563–9. DOI: 10.1002/pbc.221067. De Lellis R. The adrenal glands. In: Diagnostic Surgical Pathology, 3rd ed. Edited by Sternberg S.S. Philadelphia: Lippincott Williams & Wilkins; 1999; 1 (14): 589– 623.De Lellis R. The adrenal glands. In: Diagnostic Surgical Pathology, 3rd ed. Edited by Sternberg S.S. Philadelphia: Lippincott Williams & Wilkins; 1999; 1 (14): 589– 623.8. Brodeur G.M., Nakagawara A., Yamashiro D.J., Ikegaki N., Liu X.G., Azar C.G., et al. Expression of TrkA, TrkB and TrkC in human neuroblastomas. Neurooncol 1997; 31 (1–2): 49–55.Brodeur G.M., Nakagawara A., Yamashiro D.J., Ikegaki N., Liu X.G., Azar C.G., et al. Expression of TrkA, TrkB and TrkC in human neuroblastomas. Neurooncol 1997; 31 (1–2): 49–55.9. Thiele C.J., Li Z., McKee A.E. On Trk-the TrkB signal transduction pathway is an increasingly important target in cancer biology. Clin Cancer Res. 2009; 15 (19): 5962–7. DOI: 10.1158/1078-0432.CCR-08-065110Thiele C.J., Li Z., McKee A.E. On Trk-the TrkB signal transduction pathway is an increasingly important target in cancer biology. Clin Cancer Res. 2009; 15 (19): 5962–7. DOI: 10.1158/1078-0432.CCR-08-06511011. Tanaka T., Hiyama E., Sugimoto T., Sawada T., Tanabe M., Ida N. Trk A Gene expression in neuroblastoma. The clinical significance of an immunohistochemical study. Cancer 1995; 76 (6): 1086–95. DOI: 10.1002/1097-0142(19950915)76:6<1086::aid-cncr2820760625>3.0.co;2-8Tanaka T., Hiyama E., Sugimoto T., Sawada T., Tanabe M., Ida N. Trk A Gene expression in neuroblastoma. The clinical significance of an immunohistochemical study. Cancer 1995; 76 (6): 1086–95. DOI: 10.1002/1097-0142(19950915)76:6<1086::aid-cncr2820760625>3.0.co;2-812. Строганова А.М., Карселадзе А.И. Нейробластома: морфологическая структура, молекулярно-генетические особенности и прогностические факторы. Успехи молекулярной онкологии 2016; 3 (1): 32–43. DOI: 10.17650/2313-805X.2016.3.1.32-43Строганова А.М., Карселадзе А.И. Нейробластома: морфологическая структура, молекулярно-генетические особенности и прогностические факторы. Успехи молекулярной онкологии 2016; 3 (1): 32–43. DOI: 10.17650/2313-805X.2016.3.1.32-4313. Kaufman M.R., Rhee J.S., Fuegelman L.J., Costantino P.D. Ganglioneuroma of the Parapharyngeal Space in a Pediatric Patient. Otolaryngol Head Neck Surg 2001; 124 (6): 702–4. DOI: 10.1177/019459980112400625Kaufman M.R., Rhee J.S., Fuegelman L.J., Costantino P.D. Ganglioneuroma of the Parapharyngeal Space in a Pediatric Patient. Otolaryngol Head Neck Surg 2001; 124 (6): 702–4. DOI: 10.1177/01945998011240062514. Cushing H., Wolbach S.B. The Transformation of a Malignant Paravertebral Sympathicoblastoma into a Benign Ganglioneuroma. Am J Pathol 1927; 3 (3): 203–16.7.Cushing H., Wolbach S.B. The Transformation of a Malignant Paravertebral Sympathicoblastoma into a Benign Ganglioneuroma. Am J Pathol 1927; 3 (3): 203–16.7.15. Spinelli C., Rossi L., Barbetta A., Ugolini C., Strambi S. Incidental ganglioneuromas: a presentation of 14 surgical cases and literature review. J Endocrinol Invest 2015; 38: 547–54. DOI: 10.1007/s40618-014-0226-ySpinelli C., Rossi L., Barbetta A., Ugolini C., Strambi S. Incidental ganglioneuromas: a presentation of 14 surgical cases and literature review. J Endocrinol Invest 2015; 38: 547–54. DOI: 10.1007/s40618-014-0226-y16. Caballero O., Ferris J., Verdeguer A., Esquembre C., Castel V. Visualization of a ganglioneuroma by means of scintigraphy with 131-I-MIBG. Eur J Nucl Med 1986; 12 (7): 351–2. DOI:10.1007/bf00263818Caballero O., Ferris J., Verdeguer A., Esquembre C., Castel V. Visualization of a ganglioneuroma by means of scintigraphy with 131-I-MIBG. Eur J Nucl Med 1986; 12 (7): 351–2. DOI:10.1007/bf0026381817. Allende D.S., Hansel D.E, MacLennan G.T. Ganglioneuroma of the Adrenal Gland. J Urol 2009: 182 (2): 714–5. DOI: 10.1016/j.juro.2009.05.036Allende D.S., Hansel D.E, MacLennan G.T. Ganglioneuroma of the Adrenal Gland. J Urol 2009: 182 (2): 714–5. DOI: 10.1016/j.juro.2009.05.03618. Kara T., Oztunali C. Radiologic findings of thoracic scoliosis due to giant ganglioneuroma. Clin Imaging 2013; 37: 767–8. DOI: 10.1016/j.clinimag.2012.11.003Kara T., Oztunali C. Radiologic findings of thoracic scoliosis due to giant ganglioneuroma. Clin Imaging 2013; 37: 767–8. DOI: 10.1016/j.clinimag.2012.11.00319. Decarolis B., Simon T., Krug В., Leuschner I., Vokuhl C., Kaatsch P., et al. Treatment and outcome of Ganglioneuroma and Ganglioneuroblastoma intermixed. BMC Cancer 2016; 16: 542. DOI: 10.1186/s12885-016-2513-9Decarolis B., Simon T., Krug В., Leuschner I., Vokuhl C., Kaatsch P., et al. Treatment and outcome of Ganglioneuroma and Ganglioneuroblastoma intermixed. BMC Cancer 2016; 16: 542. DOI: 10.1186/s12885-016-2513-920. Miyake M., Tateishi U., Maeda T., Arai Y., Seki K., Hasegawa T., et al. A case of ganglioneuroma presenting abnormal FDG uptake. Ann Nucl Med 2006; 20 (5): 357–60. DOI: 10.1007/bf02987247Miyake M., Tateishi U., Maeda T., Arai Y., Seki K., Hasegawa T., et al. A case of ganglioneuroma presenting abnormal FDG uptake. Ann Nucl Med 2006; 20 (5): 357–60. DOI: 10.1007/bf0298724721. Lima A.F., Moreira F.C., Menezes A., Dias L. Cervical Ganglioneuroma in Pediatric Age: A Case Report Antonio. Turk Arch Otorhinolaryngol 2018; 56 (4): 237–40. DOI: 10.5152/tao.2018.3690Lima A.F., Moreira F.C., Menezes A., Dias L. Cervical Ganglioneuroma in Pediatric Age: A Case Report Antonio. Turk Arch Otorhinolaryngol 2018; 56 (4): 237–40. DOI: 10.5152/tao.2018.369022. Jung H.R., Kang K.J., Kwon J.H., Kang Y.N. Adrenal ganglioneuroma with hepatic metastasis. J Korean Surg Soc 2011; 80 (4): 297–300. DOI: 10.4174/jkss.2011.80.4.297Jung H.R., Kang K.J., Kwon J.H., Kang Y.N. Adrenal ganglioneuroma with hepatic metastasis. J Korean Surg Soc 2011; 80 (4): 297–300. DOI: 10.4174/jkss.2011.80.4.29723. Garvin J.H., Lack E.E., Berenberg W., Frantz C.N. Ganglioneuroma presenting with differentiated skeletal metastases. Report of a case. Cancer 1984; 54 (2): 357–60. DOI: 10.1002/1097-0142(19840715)54:2<357::aid-cncr2820540230>3.0.co;2-4Garvin J.H., Lack E.E., Berenberg W., Frantz C.N. Ganglioneuroma presenting with differentiated skeletal metastases. Report of a case. Cancer 1984; 54 (2): 357–60. DOI: 10.1002/1097-0142(19840715)54:2<357::aid-cncr2820540230>3.0.co;2-424. Adas M., Koc B., Adas G., Ozulker F., Aydin T. Ganglioneuroma presenting as an adrenal incidentaloma: a case report. J Med Case Rep 2014; 8: 131. DOI: 10.1186/1752-1947-8-131Adas M., Koc B., Adas G., Ozulker F., Aydin T. Ganglioneuroma presenting as an adrenal incidentaloma: a case report. J Med Case Rep 2014; 8: 131. DOI: 10.1186/1752-1947-8-13125. Shulkin B.L, Shapiro B. Current concepts on the diagnostic use of MIBG in children. J Nucl Med 1998; 39 (4): 679–88.Shulkin B.L, Shapiro B. Current concepts on the diagnostic use of MIBG in children. J Nucl Med 1998; 39 (4): 679–88.26. Vik T.A, Pfluger T., Kadota R., Castel V., Tulchinsky M., Farto J.C. (123)I-mIBG scintigraphy in patients with known or suspected neuroblastoma: Results from a prospective multicenter trial. Pediatr Blood Cancer. 2009; 52 (7): 784–90. DOI: 10.1002/pbc.21932Vik T.A, Pfluger T., Kadota R., Castel V., Tulchinsky M., Farto J.C. (123)I-mIBG scintigraphy in patients with known or suspected neuroblastoma: Results from a prospective multicenter trial. Pediatr Blood Cancer. 2009; 52 (7): 784–90. DOI: 10.1002/pbc.2193227. Sharp S.E, Gelfand M.J, Shulkin B.L. Pediatrics: diagnosis of neuroblastoma. Semin Nucl Med 2011; 41 (5): 345–53. DOI: 10.1053/j.semnuclmed.2011.05.001Sharp S.E, Gelfand M.J, Shulkin B.L. Pediatrics: diagnosis of neuroblastoma. Semin Nucl Med 2011; 41 (5): 345–53. DOI: 10.1053/j.semnuclmed.2011.05.00128. Biasotti S., Garaventa A., Villavecchia G., Cabria M., Nantron M., De Bernardi B. False-negative metaiodobenzylguanidine scintigraphy at diagnosis of neuroblastoma. Med Pediatr Oncol 2000; 35 (2): 153– 5. DOI: 10.1002/1096-911x(200008)35:2<153::aid-mpo18>3.0.co;2-7Biasotti S., Garaventa A., Villavecchia G., Cabria M., Nantron M., De Bernardi B. False-negative metaiodobenzylguanidine scintigraphy at diagnosis of neuroblastoma. Med Pediatr Oncol 2000; 35 (2): 153– 5. DOI: 10.1002/1096-911x(200008)35:2<153::aid-mpo18>3.0.co;2-729. Solanki K.K., Bomanji J., Moyes J., Mather S.J., Trainer P.J, Britton K.E. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG). Nucl Med Commun 1992; 13 (7): 513–21. DOI: 10.1097/00006231-199207000-00006Solanki K.K., Bomanji J., Moyes J., Mather S.J., Trainer P.J, Britton K.E. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG). Nucl Med Commun 1992; 13 (7): 513–21. DOI: 10.1097/00006231-199207000-0000630. Sharp S.E, Trout A.T., Weiss B.D., Gelfand M.J. MIBG in Neuroblastoma Diagnostic Imaging and Therapy. Radiographics 2016; 36 (1): 258–78. DOI: 10.1148/rg.2016150099Sharp S.E, Trout A.T., Weiss B.D., Gelfand M.J. MIBG in Neuroblastoma Diagnostic Imaging and Therapy. Radiographics 2016; 36 (1): 258–78. DOI: 10.1148/rg.201615009931. Feine U., Müller-Schauenburg W., Treuner J., Klingebiel T.H. Metaiodobenzylguanidine (MIBG) labeled with 123I/131I in neuroblastoma diagnosis and follow-up treatment with a review of the diagnostic results of the International Workshop of Pediatric Oncology held in Rome, September 1986. Med Pediatr Oncol 1987; 15 (4): 181–7. DOI: 10.1002/mpo.2950150408Feine U., Müller-Schauenburg W., Treuner J., Klingebiel T.H. Metaiodobenzylguanidine (MIBG) labeled with 123I/131I in neuroblastoma diagnosis and follow-up treatment with a review of the diagnostic results of the International Workshop of Pediatric Oncology held in Rome, September 1986. Med Pediatr Oncol 1987; 15 (4): 181–7. DOI: 10.1002/mpo.295015040832. Heyman S/. Evans A.E., D'Angio G.J. I-131 metaiodobenzylguanidine: diagnostic use in neuroblastoma patients in relapse. Med Pediatr Oncol 1988; 16 (5): 337–40. DOI: 10.1002/mpo.2950160509Heyman S/. Evans A.E., D'Angio G.J. I-131 metaiodobenzylguanidine: diagnostic use in neuroblastoma patients in relapse. Med Pediatr Oncol 1988; 16 (5): 337–40. DOI: 10.1002/mpo.295016050933. Fendler W.P., Wenter V., Thornton H.I., Ilhan H., von Schweinitz D., Coppenrath E. Combined Scintigraphy and Tumor Marker Analysis Predicts Unfavorable Histopathology of Neuroblastic Tumors with High Accuracy. PLoS One 2015; 10 (7): e0132809. DOI: 10.1371/journal.pone.0132809Fendler W.P., Wenter V., Thornton H.I., Ilhan H., von Schweinitz D., Coppenrath E. Combined Scintigraphy and Tumor Marker Analysis Predicts Unfavorable Histopathology of Neuroblastic Tumors with High Accuracy. PLoS One 2015; 10 (7): e0132809. DOI: 10.1371/journal.pone.013280934. Кайлаш A., Киреева Е.Д., Вдовина И.С., Ядгаров М.Я., Шаманская Т.В., Рощин В.Ю. Неинвазивное определение неблагоприятного гистологического варианта у детей с нейрогенными опухолями по накоплению ¹²³I-МЙБГ с использованием полуколичественной и количественной оценок. Вопросы гематологии/онкологии и иммунопатологии в педиатрии 2020; 19 (1): 68–78. DOI: 10.24287/1726-1708-2020-19-1-68-78Кайлаш A., Киреева Е.Д., Вдовина И.С., Ядгаров М.Я., Шаманская Т.В., Рощин В.Ю. Неинвазивное определение неблагоприятного гистологического варианта у детей с нейрогенными опухолями по накоплению ¹²³I-МЙБГ с использованием полуколичественной и количественной оценок. Вопросы гематологии/онкологии и иммунопатологии в педиатрии 2020; 19 (1): 68–78. DOI: 10.24287/1726-1708-2020-19-1-68-7835. Rozmus J., Langer M., Murphy J.J, Dix D. Multiple persistent ganglioneuromas likely arising from the spontaneous maturation of metastatic neuroblastoma. J Pediatr Hematol Oncol 2012; 34 (2): 151–3. DOI: 10.1097/MPH.0b013e318221ca82Rozmus J., Langer M., Murphy J.J, Dix D. Multiple persistent ganglioneuromas likely arising from the spontaneous maturation of metastatic neuroblastoma. J Pediatr Hematol Oncol 2012; 34 (2): 151–3. DOI: 10.1097/MPH.0b013e318221ca8236. Sаnchez-Galаn А., Barrena S., Vilanova-Sánchez A. Martín S., Lopez-Fernandez S., García P. Ganglioneuroma: to operate or not to operate. Eur J Pediatr Surg 2014; 24 (1): 25–30. DOI: 10.1055/s-0033-1358790Sаnchez-Galаn А., Barrena S., Vilanova-Sánchez A. Martín S., Lopez-Fernandez S., García P. Ganglioneuroma: to operate or not to operate. Eur J Pediatr Surg 2014; 24 (1): 25–30. DOI: 10.1055/s-0033-135879037. Качанов Д.Ю., Шаманская Т.В., Коновалов Д.М., Ликарь Ю.Н., Рощин В.Ю., Муфтахова Г.М. Ганглионейрома у детей. Вопросы гематологии/онкологии и иммунопатологии в педиатрии 2014; 13 (3): 33–41.Качанов Д.Ю., Шаманская Т.В., Коновалов Д.М., Ликарь Ю.Н., Рощин В.Ю., Муфтахова Г.М. Ганглионейрома у детей. Вопросы гематологии/онкологии и иммунопатологии в педиатрии 2014; 13 (3): 33–41.38. Camelo М., Aponte L., Lugo-Vicente H. Dopamine-secreting adrenal ganglioneuroma in a child: beware of intraoperative rebound hypertension. J Pediatr Surg 2012; 47 (9): Е29–32. DOI: 10.1016/j.jpedsurg.2012.04.017Camelo М., Aponte L., Lugo-Vicente H. Dopamine-secreting adrenal ganglioneuroma in a child: beware of intraoperative rebound hypertension. J Pediatr Surg 2012; 47 (9): Е29–32. DOI: 10.1016/j.jpedsurg.2012.04.01739. Alexander N., Sullivan K., Shaikh F., Irwin M. Characteristics and management of ganglioneuroma and ganglioneuroblastoma-intermixed in children and adolescents. Pediatr Blood Cancer 2018; 65 (5): 1–9. DOI:10.1002/pbc.26964Alexander N., Sullivan K., Shaikh F., Irwin M. Characteristics and management of ganglioneuroma and ganglioneuroblastoma-intermixed in children and adolescents. Pediatr Blood Cancer 2018; 65 (5): 1–9. DOI:10.1002/pbc.26964