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[Adrenal tumors in pediatric patients treated with minimally invasive surgery].

Andes Pediatr

October 2024

Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Unlabelled: Adrenal tumors in children are frequently neoplastic and malignant, and surgical resection is the first management option. Minimally invasive surgery (MIS) has proven to be a safe management alternative and is suggested as a preferred alternative approach.

Objective: To report the surgical outcomes of patients with adrenal tumors treated by MIS.

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This report presents the case of a 62-year-old male with an incidentally discovered adrenal mass, ultimately diagnosed as a ganglioneuroma after laparoscopic adrenalectomy. Imaging findings, of a 9 cm lobulated mass with heterogeneous enhancement on MRI, were unspecific and malignancy could not be excluded. Histological examination of the specimen revealed a well-demarcated tumor composed of Schwann cells and ganglion cells, confirming the diagnosis.

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Article Synopsis
  • Ganglioneuroma (GN) is the least aggressive and most mature type of neuroblastic tumors, typically found in the chest, abdomen, and adrenal glands.
  • It primarily affects children under 10 years old, but metastasis to lymph nodes or other organs can occur very rarely.
  • The case discussed involves a 4-year-old child with a primary adrenal ganglioneuroma that had metastasized to lymph nodes, but without any immature neuroblastoma cells present.
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Article Synopsis
  • An adrenal collision tumor (ACT) consists of distinct tumors, like adrenal schwannoma and ganglioneuroma, that coexist in adrenal tissue without overlapping; these cases are rare and hard to diagnose due to unusual clinical signs and imaging results.
  • A 37-year-old man was diagnosed with a left adrenal mass, initially thought to be a pheochromocytoma, but post-surgery, it was found to be a combination of adrenal schwannoma and ganglioneuroma.
  • This case underscores the complexity of adrenal tumors, highlighting the importance of postoperative analysis for accurate diagnosis and treatment despite the challenges in identifying the type of adrenal mass before surgery.*
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Ganglioneuroma is a well-differentiated tumor originating from neural crest cells of the sympathetic nervous system. Although benign, a few cases have been reported that ganglioneuroma can metastasize to other sites. We report a case of adrenal ganglioneuroma with para-aortic nodal metastases with low FDG and MIBG uptake.

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