Primary cervical ganglioneuroblastoma: diagnostic challenges, management, and outcomes - a systematic review.
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BACKGROUND: Primary cervical ganglioneuroblastoma is rare, mimics paediatric neck lesions and abuts neurovascular structures. AIMS/OBJECTIVES: To synthesize individual-patient data on presentation, diagnosis, histology, treatment, morbidity and outcome. MATERIAL AND METHODS: Following PRISMA 2020, PubMed, Scopus and Web of Science were searched on 10 May 2026; two reviewers independently selected reports and extracted data. RESULTS: Eighteen reports described 24 patients; with an illustrative case, 25 were analysed (median age 4.5 years). Tumours involved the parapharyngeal (32%), retropharyngeal (24%) and carotid (16%) spaces. Subtype was intermixed in 10, nodular in three and unspecified in 12. Twenty-four underwent resection; seven received chemotherapy. Postoperative Horner syndrome was reported in 12 of 21 patients without documented preoperative Horner syndrome. At last assessment, 20 had no active disease, two had residual disease and one had died. In an exploratory analysis (n = 11), median diameter did not differ by Horner status (5.80 vs 5.45 cm; p = 0.982). CONCLUSIONS AND SIGNIFICANCE: Cervical ganglioneuroblastoma should be considered in children with deep-neck masses. Core-needle biopsy may provide more adequate tissue than fine-needle aspiration when tissue diagnosis is required. Favourable outcomes of intermixed tumours apply only to cases with known subtype, and surgery should aim for maximal safe resection.