Neuroblastoma (NB) is a common tumor in children but is extremely rare in adults. Sparse literature exists on adult NB or the subtype ganglioneuroblastoma (GNB). We present a 40-year-old male complaining of decreased strength and pain in his left hand. Imaging studies showed a paraspinal tumor at T1 and an abdominal mass while laboratory tests were significant for high plasma and urine metanephrines suggesting a diagnosis of pheochromocytoma. Percutaneous core needle biopsy was performed and a diagnosis of GNB was made based on immunohistochemical staining. The patient underwent debulking surgery and final pathology confirmed the diagnosis. The patient demonstrates no signs of local recurrence but developed diffuse bony metastasis after the debulking procedure. Systemic therapy regimens for GNB are largely extrapolated from pediatric regimens and efficacy is unknown. Differentiation between adult and pediatric NB remains unclear.
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