Global Journal of Surgery
ISSN (Print): 2379-8742 ISSN (Online): 2379-8750 Website: Editor-in-chief: Baki Topal
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Global Journal of Surgery. 2020, 8(1), 17-20
DOI: 10.12691/js-8-1-4
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A Rare Adrenal Incidentaloma: Case Report of a Right Adrenal Ganglioneuroma

Youssef Jakhlal1, , Ahmed Jahid2 and Settaf Abdellatif1

1Department of Digestive surgery B, Ibn Sina Teaching Hospital, Mohammed V University, Rabat, Morocco

2Department of Anatomopathology, Ibn Sina Teaching Hospital, Mohammed V University, Rabat, Morocco

Pub. Date: August 03, 2020

Cite this paper:
Youssef Jakhlal, Ahmed Jahid and Settaf Abdellatif. A Rare Adrenal Incidentaloma: Case Report of a Right Adrenal Ganglioneuroma. Global Journal of Surgery. 2020; 8(1):17-20. doi: 10.12691/js-8-1-4


Adrenal ganglioneuroma (AGN) is an extremely rare and benign tumor that originates from the neural crest tissue of the sympathetic nervous system. The majority of cases are detected incidentally. It presents a challenging preoperative diagnostic differential with other solid adrenal tumors. However, the assessment and management of AGNs are similar to other adrenal tumors. We present a case of a 40-year-old female referred to our institution for a right solid adrenal mass that was detected incidentally on an abdominal CT scan (4×5×5cm). The patient underwent laparoscopic surgical excision of the tumor. The histopathology examination showed areas of spindle cells and scattered mature ganglionic cells compatible with AGN.

adrenal ganglioneuroma imaging features laparoscopy

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[1]  Joshi VV: Peripheral neuroblastic tumors: pathologic classification based on recommendations of international neuroblastoma pathology committee (modification of shimada classification). Pediatr Dev Pathol 2000, 3: 184-199.
[2]  Geoerger B, Hero B, Harms D, Grebe J, Scheidhauer K, Berthold F: Metabolic activity and clinical features of primary ganglioneuromas. Cancer 2001, 91:1905-1913.
[3]  Enzinger FM, Weiss SW: Ganglioneuroma. In Soft Tissue Tumors 3rd edition. St Louis: Mosby-Year Book; 1995: 929-964.
[4]  Zografos GN, Kothonidis K, Ageli C, et al: Laparoscopic resection of large adrenal ganglioneuroma. JSLS 11: 487-492, 2007.
[5]  Kouriefs C, Leris AC, Mokbel K, et al: Abdominal ganglioneuromas in adults. UrolInt 71: 110113, 2003.
[6]  Ichikawa T, Koyama A, Fujimoto H, et al: Retroperitoneal ganglioneuroma extending across the midline: MR features. Clin Imaging 17: 19-21, 1993.
[7]  Rha SE, Byun JY, Jung SE, et al: Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 23: 29-43, 2003.
[8]  Qing Y, Bin X, Jian W, Li G, Linhui W, Bing L, Huiqing W, Yinghao S: Adrenal ganglioneuromas: a 10-year experience in a Chinese population. Surgery 2010, 147: 854-860.
[9]  Rhondeau G, Nolet S, Latour M, Braschi S, Gaboury L, Lacroix A, Panzini B, Arjane P, Cohade C, Bourdeau I: Clinical and biochemical features of seven adult adrenal ganglioneuromas. J ClinEndocrinolMetab 2010, 95: 3118-3125.
[10]  Allende DS, Hansel DE, MacLennan GT. Ganglioneuroma of the adrenal gland. J Urol 2009; 182: 714-715
[11]  Koch CA, Brouwers FM, Rosenblatt K, Burman KD, Davis MM, Vortmeyer AO, Pacak K. Adrenal ganglioneuroma in a patient presenting with severe hypertension and diarrhea. EndocrRelat Cancer 2003; 10: 99-107.
[12]  Gaisa NT, Klöppel G, Brehmer B, Neulen J, Stephan P, Knüchel R, Donner A. [Virilizing adrenal ganglioneuroma: A rare differential diagnosis in testosterone secreting adrenal tumours]. Pathologe 2009; 30: 407-410.
[13]  Cronin EM, Coffey JC, Herlihy D, Romics L, Aftab F, Keohane C, Redmond HP: Massive retroperitoneal ganglioneuroma presenting with small bowel obstruction 18 years following initial diagnosis. Irish J Med Sci 2005, 174:63-66.
[14]  Lonergan GJ, Schwab CM, Suarez ES, Carlson CL: Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma: radiologic-pathologic correlation. Radiographics 2002, 22: 911-934.
[15]  Yamaguchi K, Hara I, Takeda M, Tanaka K, Yamada Y, Fujisawa M, Kawabata G: Two cases of ganglioneuroma. Urology 2006, 67: 622. e1-e4.
[16]  Zugor V, Schott GE, Kühn R, Labanaris AP: Retroperitoneal ganglioneuroma in childhood-a presentation of two cases. Ped Neonatology 2009, 50: 173-176.
[17]  Otal P, Mezghani S, Hassissene S, Maleux G, Colombier D, Rousseau H, Joffre F: Imaging of retroperitoneal ganglioneuroma. European Radiology 2001, 11:940-945.
[18]  Sasaki S, Yasuda T, Kaneto H, Otsuki M, Tabuchi Y, Fujita Y, Kubo F, Tsuji M, Fujisawa K, Kasami R, Kitamura T, Miyatsuka T, Katakami N, Kawamori D, Matsuoka TA, Imagawa A, Shimomura I. Large adrenal ganglioneuroma. Intern Med 2012; 51: 2365-2370
[19]  Mackie GC, Shulkin BL, Ribeiro RC, Worden FP, Gauger PG, Mody RJ, Connolly LP, Kunter G, Rodriguez-Galindo C, Wallis JW, Hurwitz CA, Schteingart DE. Use of [18F] fluorodeoxyglucose positron emission tomography in evaluating locally recurrent and metastatic adrenocortical carcinoma. J ClinEndocrinolMetab 2006; 91: 2665-2671.
[20]  Adas M, Koc B, Adas G, Ozulker F, Aydin T. Ganglioneuroma presenting as an adrenal incidentaloma: a case report. J Med Case Rep 2014; 8: 131.
[21]  Diab DL, Faiman C, Siperstein AE. Virilizing adrenal ganglioneuroma in a woman with subclinical Cushing syndrome. EndocrPract 2008; 14(5): 584-587.
[22]  Maweja S, Materne R, Detrembleur N, et al. Adrenal ganglioneuroma. Am J Surg 2007;194(5):683-684.
[23]  Economopoulos KP, Mylonas KS, Stamou AA, Theocharidis V, Sergentanis TN, Psaltopoulou T, Richards ML. Laparoscopic versus robotic adrenalectomy: A comprehensive meta-analysis. Int J Surg 2017; 38: 95-104.
[24]  Shawa H, Elsayes KM, Javadi S, Morani A, Williams MD, Lee JE, Waguespack SG, Busaidy NL, Vassilopoulou-Sellin R, Jimenez C, Habra MA. Adrenal ganglioneuroma: features and outcomes of 27 cases at a referral cancer centre. ClinEndocrinol (Oxf) 2014; 80: 342-347.
[25]  Ordóñez NG. Value of GATA3 immunostaining in tumor diagnosis: a review. AdvAnatPathol 2013; 20: 352-360