According to the International Neuroblastoma Staging System (INSS), there are six stages of ganglioneuroma based on clinical, radiologic, and surgical features.^[1]

According to the International Neuroblastoma Staging System (INSS), there are six stages of ganglioneuroma based on clinical, radiologic, and surgical features.^[1]

Stage 1

• Localized tumor confined to the area of origin
• Complete gross excision, with or without microscopically residual disease
• Identifiable ipsilateral and contralateral lymph node negative microscopically

Stage 2A

• Unilateral tumor with incomplete gross excision
• Identifiable ipsilateral nonadherent lymph node negative microscopically

Stage 2B

• Unilateral tumor with complete or incomplete gross excision
• Positive ipsilateral nonadherent lymph nodes
• Identifiable contralateral lymph node negtive microscopically

Stage 3

• Tumor infiltrating across the midline (vertebral column) with or without regional lymph node involvement

OR

• Unilateral tumor with contralateral regional lymph node involvement

OR

• Midline tumor with bilateral regional lymph node involvement or extension by infiltration

Stage 4

• Dissemination of tumor to distant lymph nodes, bone, bone marrow, liver or other organs (except as defined in stage 4S)

Stage 4S

• Localized primary tumor as defined for stage 1 or 2 with dissemination limited to liver, skin, and/or bone marrow (<10% tumor) in infants younger than 1 yr

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