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CASE REPORT
Year : 2011  |  Volume : 3  |  Issue : 7  |  Page : 336-338

Ganglioneuroma of the adrenal gland and retroperitoneum: A case report


1 Department of Surgery, Abington Memorial Hospital, Abington, PA., USA
2 Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA
3 Department of Surgery, Kalispell Regional Medical Center, Kalispell, MT, USA

Correspondence Address:
Iswanto Sucandy
Department of General and Vascular Surgery, Abington Memorial Hospital 1200 Old York Road, Abington, PA. 19001
USA
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Source of Support: None, Conflict of Interest: None


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Context: Ganglioneuromas are benign tumors of the sympathetic nervous system that rarely arise in the adrenal gland. Majority of cases are detected incidentally since they are usually asymptomatic. Up to the current era of laparoscopic adrenal mass excision, this unusual entity has not been adequately reported in the surgical literature. Case Report: A 51 year old male with history of hypertension was found to have abdominal bruit during a regular physical examination. A 4 cm right adrenal mass with upper pole calcification and a 6 cm retro-pancreatic mass were subsequently found on a computed tomography scan. Endoscopic ultrasound-guided needle biopsy was indeterminate. Preoperative endocrine evaluation showed mildly elevated vanillyl mandelic acid with normal 24-hour cathecolamine, metanephrine and cortisol levels. Histopathologic examination after an uneventful laparoscopic excision was consistent with ganglioneuroma. Conclusions: Ganglioneuroma occurs rarely in adrenal gland and preoperative diagnosis is difficult since symptoms are usually nonspecific. Due to widespread utilization of abdominal imaging, however, it should be included in differential diagnosis of adrenal or retroperitoneal mass. Histopathologic examination is currently the mainstay of diagnosis.


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