Dumbbell neuroblastoma or ganglioneuroma of the spinal canal

Four cases of neuroblastoma or ganglioneuroma presenting as dumbbell or hourglass tumors of the spinal canal are reported. It is suggested that when such a radiographic configuration is encountered in an infant or young child, the first diagnostic considerations be neuroblastoma or ganglioneuroma. This is most important since the early clinical findings may be mild and nonspecific. In other cases, neurological findings may so overshadow the clinical picture, that the initial diagnostic considerations are those of primary spinal cord tumor or some other primary spinal cord problem. The differential diagnosis includes metastatic neuroblastoma to the spine, histiocytosis X of the spine, tuberculous or pyogenic osteomyelitis, neurofibroma and other spinal tumors, and generalized neurofibromatosis. X ray differentiation of these lesions is usually readily accomplished, and, thereafter, one can usually suggest the correct diagnosis.