What are the other Names for this Condition? (Also known as/Synonyms)

• Colonic Ganglioneuroma
• Colonic Mucosal Ganglioneuroma
• Mucosal Ganglioneuroma of Colon

What is Ganglioneuroma of Colon? (Definition/Background Information)

• Ganglioneuroma of Colon is a rare, benign, non-cancerous lesion that forms in the colon (large intestine). Ganglioneuromas are not pre-malignant - meaning that individuals are not at an increased risk for developing colon cancer
• It can occur in middle-aged and older men and women aged around 50 years
• Ganglioneuroma of Colon lesions are usually less than 1 cm in size (some may be as large as 3 cm too). They usually occur as a single mass; though multiple lesions have been observed
• A complete surgical removal of the lesion results in a cure. The prognosis of Ganglioneuroma of Colon is excellent and it does not recur after removal

There are different types of Ganglioneuroma of Colon and these include:

• Solitary type of Ganglioneuroma of Colon: It is not associated with any syndromes
• Multiple mucosal type of Ganglioneuroma of Colon: Also known as ganglioneuromatous polyposis, it can be associated with certain syndromes
• Diffuse type of Ganglioneuroma of Colon: It commonly occurs in the terminal ileum, appendix, or cecum. This type can be associated with certain syndromes

Who gets Ganglioneuroma of Colon? (Age and Sex Distribution)

• Ganglioneuroma of Colon usually arises in older adults (both men and women are affected); most commonly in individuals aged 50 years and over
• However, they can be found in individuals of all ages
• No racial or ethnic predilection is observed

What are the Risk Factors for Ganglioneuroma of Colon? (Predisposing Factors)

The specific risk factors of Ganglioneuroma of Colon are unknown in a majority of cases. In some cases, the risk factors may include:

• PTEN hamartomatous tumor syndrome (a unified syndrome that includes Cowden disease and Bannayan-Ruvalcaba-Riley syndrome)
• Familial adenomatous polyposis (FAP)
• Juvenile polyposis
• MEN type 2B, for diffuse ganglioneuromatosis
• Neurofibromatosis type 1 (NF1), for diffuse ganglioneuromatosis
• Smoking
• Inflammatory bowel disease

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Ganglioneuroma of Colon? (Etiology)

In a majority of cases, the cause of formation of Ganglioneuroma of Colon is unknown.

• Colonic Ganglioneuromas are benign hamartomatous tumors that arise from the autonomic nervous system
• The tumor may also occur due to certain genetic mutations that predispose an individual to developing these polyps

What are the Signs and Symptoms of Ganglioneuroma of Colon?

A majority of Ganglioneuroma of Colon lesions do not cause any significant symptoms. They may be found incidentally during a colonoscopy that may be performed for other health condition.

Rarely, the signs and symptoms of Ganglioneuroma of Colon may include:

• Presence of small lesions/polyps in the colon (typically less than 1 cm in size)
• Bleeding from the anus
• Mucus mixed with stools
• Diarrhea
• Constipation
• Weight loss

Also, in rare cases, the tumor may secrete abnormal amounts of hormones causing symptoms such as:

• Abnormal sweating
• Anxiety
• High blood pressure
• Difficulty falling asleep
• Increased body hair growth

Most ganglioneuromas are found in the distal part of the colon, which includes the sigmoid colon and rectum. They can rarely be seen in the right colon or small intestine.

How is Ganglioneuroma of Colon Diagnosed?

A diagnosis of Ganglioneuroma of Colon would involve:

• Physical exam and evaluation of medical history
• Screening colonoscopy: Ganglioneuroma of Colon are diagnosed during colonoscopies. A colonoscopy is a test that allows the physician to look at the inner lining of the colon and rectum. A typical colonoscopy involves using a thin, flexible tube (called a colonoscope), with an attached video camera, to view the colon and rectum. A polyp will show up as a bump and can be removed during the colonoscopy and sent for testing
• A tissue biopsy of the tumor (polyp) is performed and sent to a laboratory for a pathological examination
  • A pathologist examines the biopsy under a microscope. If it is indeed a polyp, a distinct appearance is noted by the pathologist. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
  • Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
  • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
  • Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

A differential diagnosis may be performed to exclude other tumor types before arriving at a diagnosis. This may include:

• Perineurioma
• Granular cell tumor
• Schwann Cell Hamartoma
• Inflammatory fibroid polyp
• Schwannoma
• Neurofibroma
• Mucosal prolapse (cloacogenic polyp)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Ganglioneuroma of Colon?

Ganglioneuromas of Colon are normally not harmful due to their benign nature. Therefore, any complications arising from such polyps are typically minimal.

How is Ganglioneuroma of Colon Treated?

• Due to the benign (non-cancerous) nature of Ganglioneuroma of Colon, they do not generally require any treatment
• They are also not inherently harmful to the body. However, Colonic Ganglioneuromas are normally removed to confirm the diagnosis
• Typically, they are removed during a colonoscopy and sent for testing, in order to ensure that they are not cancerous or harmful

How can Ganglioneuroma of Colon be Prevented?

Currently, no known preventive methods exist for Ganglioneuroma of Colon.

• One can lower one’s risk of developing polyps by eating a healthy diet and maintaining a healthy lifestyle
  • This includes eating lots of fruits, vegetables, and whole grains; high fat foods should be consumed less
  • One must exercise for at least 30 minutes each day
• In general, folic acid and calcium supplements may also reduce the risk of formation of colon polyps

What is the Prognosis of Ganglioneuroma of Colon? (Outcomes/Resolutions)

• The prognosis for individuals with Ganglioneuroma of Colon is generally excellent
• Since, there is no risk of these polyps developing into cancer; they do not have a clinical significance. Most individuals are able to carry on with a normal quality of life

Additional and Relevant Useful Information for Ganglioneuroma of Colon:

The following article link will help you understand colonoscopy screening procedure.

https://www.dovemed.com/common-procedures/procedures-surgical/colonoscopy/