Discussion: Retroperitoneal ganglioneuromas are rare benign tumours that originate from neural crest-derived cells of the paravertebral sympathetic plexus and sometimes from the adrenal medulla. They are usually asymptomatic and discovered on routine clinical examination or autopsy. Occasionally, they may show symptoms due to a local pressure effect or rarely they are hormonally active and present with adrenergic symptoms. Complete resection of the tumour is important to establish the final diagnosis and alleviate symptoms from pressure effects.

Conclusion: This case highlights the need for great vigilance among physicians to consider any possible retroperitoneal pathology when indicated in the differential diagnosis of lower back and leg pain, before establishing other more common diagnoses, especially in the older population.

Reference: https://pubmed.ncbi.nlm.nih.gov/33437470/