Laparoscopic excision of a large Adrenal Ganglioneuroma masquerading as Pheochromocytoma- A case report & review of literature

Left Adrenal Ganglioneuroma Treated by Laparoscopic Adrenalectomy in a 41-Year-Old Woman: A Case Report

“…Abdominal and/or back pain is the most frequently reported symptom secondary to a mass effect [ 1 – 4 ]. In case of excess secretion of catecholamines or steroid hormones (indicative of a hormonally active disease), the patient may develop specific symptoms such as diarrhea, hypertension, weakness, and virilization [ 1 , 3 , 6 ], but these symptoms were absent in our patient.…”

“…Abdominal CT is a valuable imaging tool for detecting adrenal masses [ 1 – 3 ]. CT findings that are indicative of AGNs include the observation of a well-defined, encapsulated mass with a lobular and solid appearance and an iso- to hypo-attenuating lesion in contrast to muscle signals.…”

“…AGNs comprise mature Schwann cells, ganglion cells, and nerve fibers [ 2 ]. Considering the rarity of AGNs, their pathogenesis is not fully understood [ 3 ]. Moreover, their heterogeneous presentation makes the preoperative differential diagnosis of AGNs challenging [ 1 – 4 ].…”

“…Most patients with AGNs are asymptomatic, and these tumors are mostly discovered incidentally during abdominal imaging performed for other unrelated reasons [ 3 , 4 ]. Importantly, no specific imaging features are considered as pathognomic for AGNs [ 3 , 4 ].…”

“…Given the difficulty of making a preoperative diagnosis of AGN and the possibility of malignancy, particularly if the tumor size is larger than 6 cm, all reports recommend adrenalectomy as the appropriate treatment for AGNs [ 1 – 4 ]. Furthermore, most studies do not recommend wide excision because AGNs rarely recur or metastasize [ 1 – 3 ].…”