《Table 1 Summary of previously reported cases with cervical bilateral dumbbell ganglioneuromas》

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《Bilateral and symmetric C1-C2 dumbbell ganglioneuromas associated with neurofibromatosis type 1: A case report》

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PR:Partial resection；TR:Total resection.

GN was first described in 1870[14].Since then，an increasing number of related case reports have been published，providing comprehensive data and knowledge.GN incidence is not well documented，although reports suggested that it may account for0.1 to 0.5%of central nervous system tumors[15].GN rarely involves the cervical region，compressing the spinal cord.Meanwhile，bilateral dumbbell GNs with NF-1 in the cervical region are even rarer.Only five cases have been reported in the current English literature（Table 1）.Of these cases，three showed intradural extension and two displayed extradural growth；the current case also involved the extradural space.However，in the majority of cases whether multiple or single，given that these tumors originate from sensory root ganglions，extradural extension from the intervertebral foramen is more common.Stout et al[16]reported a male/female ratio of GN of approximately 2/3，but the cases summarized here were all male and NF-1 is irrespective of gender or ethnicity[17].Whether gender difference exists in GN remains unknown.Weiss reported that GN is most frequently diagnosed in patients aged between 10 and 29 years[18].The mean age at diagnosis of our six cases was 37 years，ranging from 15 to 72 years.This difference may be associated with symptom severity and patient enthusiasm for the hospital.Besides，NF-1 is usually present during the first decade of life and malignancies occur up to four to six times more common in patients with NF-1 than in the general population[9].Therefore，GN associated with NF-1 seems to be more likely to diagnose earlier.