Ganglioneuroma is a benign neuroectodermal tumor that is composed of ganglion and Schwann cells. In contrast to neuroblastoma and ganglioneuroblastoma, it contains no immature neuroblastic elements. The most common locations are posterior mediastinum and retroperitoneum followed by adrenal gland. Other sites where ganglioneuromas may be found include skin, pharynx, paratesticular region, and gastrointestinal tract. The photograph shows a 5.0 cm, well-circumscribed, firm, multinodular ganglioneuroma that arose in the adrenal. Gross photograph courtesy of: Dr. Alfred Campbell, Spartanburg, South Carolina.