Ganglioneuromas (GNs) are well‑differentiated, rare benign tumors of neural crest origin and are, for the most part, considered to
be the benign equivalent of neuroblastomas. There are very few cases of GN reported to be at presacral location in the literature.
The standard form of treatment is the total surgical excision. However, total resection of GN is not always possible depending on the
neuron, from which it originates, and its localization. Moreover, adjuvant radiotherapy (RT) or chemotherapy is not recommended
even though patients are still symptomatic after subtotal resection. This view is based on the urban legend that it undergoes a
malignant transformation although it is a benign tumor. Moreover, there are no data indicating that the GN cases reported in the
literature have undergone RT. Therefore, articles about the suspicion that GN may undergo spontaneous or malignant transformation
after RT are absolutely controversial. Based on our case, we present here, we believe that we will explain the valid necessity of
application of RT that we administered for the first time and that with the clarification of this controversial topic, a significant gap
will be closed in the literature.