Adrenal Ganglioneuroma: A Rare Case Report and Literature Review

Abstract

Submit Manuscript | http://medcraveonline.com hyperaldosteronism, hypertension and hypercortisolism. Further examination was taken in our hospital. The contrast-enhanced CT identified a quasi-circular nodular lesion in the right adrenal gland, measuring 6x6.5cm and displaying heterogeneous with mottling and spotty dense calcification on the edge of the mass. The margin of lesion was clear and presented 46 HU in plain scan and 68-113 HU in the enhancement. The tumor surrounded the right renal vein and part of postcava, but didn't narrow the vessels (Figure 1). All of functional laboratory evolution showed negative including blood testing for catecholamines (epinephrine and norepinephrine) and their metabolites (metanephrine in serum and VMA in a 24-hour urine sample), free cortisol and ACTH (adrenocorticotropic hormone) in serum and plasma testing for renin-angiotensin-aldosterone under recumbent and upright state. A laparoscopic right adrenalectomy was performed ( Figure 2) and postoperative pathology revealed a right ganglioneuroma. Immunohistochemistry showed S-100, CD56, Syn and CgA staining are positive (Figure 3 & 4). After one year follow-up, the patient has not had any local recurrence and distant metastasis. AbstractBackground: Adrenal ganglioneuroma is a rare sympathetic tumor which originated from adrenal medulla [1]. Multi slice spiral CT and 3d reconstruction have gradually been considered as one of the most important technical for discovery and identification of the incidentalomas. However, the accurate diagnosis of this tumor remains a challenge due to its nonspecific clinic and radiological performance. This report presents the clinic and radiological data for the infrequent tumor which should share some experience to facilitate the criteria for the diagnosis of adrenal ganglioneuroma.