July - September 2015, Volume 11, Issue 3

Balanescu RN, Balanescu L, Moga AA, Dragan GC, Caragata RF, Djendov FB

Laparoscopic Resection of Adrenal Ganglioneuromas in a 13 Year Old Patient

Acta Endo (Buc) 2015, 11 (3): 377-380
doi: 10.4183/aeb.2015.377

Introduction. Ganglioneuromas are rare, benign tumors that arise from the neural crest tissue and are usually asymptomatic and discovered accidentally. GN have good prognosis with surgical removal and the standard treatment for such lesions is laparoscopic adrenalectomy. Case report. We report the case of a 13 year old patient who presented to our hospital with abdominal pain. The ultrasound and the CT scan confirmed the presence of a well-defined mass situated in the right renal space. Taking into account the size of the tumor, its position and the fact that CT scan showed no local signs of invasion, the decision was taken to perform a laparoscopic removal of the right adrenal mass. After dividing the main adrenal vein and while dissecting the adrenal gland, we noticed an intraoperative bleeding due to the fact that one of the clips used to ligate the vein had slipped. Because we were unable to control the intraoperative bleeding we decided to convert to open surgery. The histopathological result showed that the adrenal lesion was a ganglioneuroma. Conclusion. While the role of minimal invasive adrenalectomy in patients with larger lesion is still controversial, advantages such as reduced hospital stay and postoperative morbidity, lower rate of complications, have resulted in the laparoscopic approach for adrenal pathology becoming the choice procedure in the removal of adrenal lesion.

Keywords: Adrenal tumor, laparoscopy, excision

Correspondence: Laura Balanescu MD, “Grigore Alexandrescu” Emergency Hospital for Children, Bdul Iancu de Hunedoara 30-32, Bucharest, 040587, Romania, E-mail: laura7balanescu@yahoo.com