RadOnc Resident Wiki/Autonomic Nervous System

Tumors of the autonomic nervous system are relatively rare but can occur. The autonomic nervous system (ANS) controls involuntary bodily functions such as heart rate, digestion, respiratory rate, and pupillary response. It consists of two main branches: the sympathetic nervous system and the parasympathetic nervous system. Tumors that arise within or affect these components of the ANS can have various clinical manifestations and may be benign or malignant.

Here are some key points about tumors of the autonomic nervous system:

  • Types of Tumors: The most common type of tumor that affects the autonomic nervous system is a neuroblastoma. Neuroblastomas are often seen in children and typically arise from immature nerve cells. They can develop anywhere along the sympathetic nervous system, but they are most commonly found in the adrenal glands, which are located on top of each kidney.
    • Sympathetic Ganglioneuroma: This is a benign tumor that develops from nerve cells within sympathetic ganglia. It can occur in various locations along the sympathetic chain, including the chest, abdomen, and pelvis.
    • Paraganglioma: These tumors are typically benign, but they can be locally invasive. They originate from extra-adrenal paraganglia, which are clusters of specialized cells related to the sympathetic nervous system. Paragangliomas can develop in various areas of the body, including the head and neck, chest, and abdomen.
    • Pheochromocytoma: This is a rare type of tumor that arises in the adrenal glands. It is usually benign but can produce excessive amounts of catecholamines, which are hormones that regulate blood pressure and heart rate. As a result, pheochromocytomas can lead to severe hypertension and other symptoms.
  • Symptoms: The symptoms of autonomic nervous system tumors can vary depending on their location and whether they are benign or malignant. Common symptoms may include high blood pressure, rapid heart rate, abdominal pain, weight loss, and other signs of sympathetic nervous system dysfunction.
  • Diagnosis: Diagnosis typically involves a combination of imaging studies such as CT scans, MRIs, and specialized nuclear medicine tests. Biopsy or fine-needle aspiration may be required to confirm the type of tumor.
  • Treatment: Treatment options depend on the type, location, and stage of the tumor. Benign tumors may be surgically removed, and individuals often recover well. Malignant tumors may require a combination of surgery, chemotherapy, radiation therapy, and other targeted treatments. Pheochromocytomas, for example, often require medication to control blood pressure before surgery.
  • Prognosis: The prognosis for individuals with autonomic nervous system tumors varies widely. Benign tumors are usually associated with a good prognosis, while malignant tumors can be more challenging to treat and have a less favorable outlook.

It's important to note that while these tumors are rare, early detection and appropriate medical intervention are crucial for the best possible outcome. Medical professionals with expertise in neurology, oncology, and surgery are typically involved in the diagnosis and management of autonomic nervous system tumors.