Ganglioneuromas may arise de novo or in patients who have had chemotherapyfor metastatic neuroblastoma. Typically, they enlarge slowly; rapid growthshould raise suspicion for a poorly differentiated neoplasm. Neoplasms ofprimitive neuroectodermal origin, such as neuroblastoma, contain pluripotentcells that have the capacity to differentiate into mature cellular elements,such as ganglion cells.8 When ganglion celldifferentiation is present within an otherwise typical neuroblastoma, theterm ganglioneuroblastoma is appropriate. In the present case, clinical uncertaintyregarding cellular composition coupled with progressive proptosis and itsassociated corneal complication prompted debulking of the lesion. The historyof metastatic neuroblastoma and the presence of multiple ganglioneuromas lendcredence to the theory purporting the presence of rests of metastatic neuroblastomathat subsequently undergo maturation. Ganglioneuromas, as fully differentiatedneoplasms, do not have the capability to metastasize, so extensive surgicalresections or chemotherapy is not normally necessary, provided surgical samplingis sufficient to allow adequate histologic analysis and to assure no neuroblasticcellular elements are present. Excision may be considered when the pathologicdiagnosis is uncertain or visual function is compromised by the neoplasm.