Adrenal ganglioneuromas: a 10-year experience in a Chinese population

Adrenal ganglioneuroma (GN) is extremely rare. The present study is to describe the largest series of this adrenal tumor treated in a single medical center to our knowledge.

Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analyzed retrospectively in 17 patients with incidentally discovered adrenal GN who received operative resection at a tertiary referral hospital in eastern China between June 1999 and June 2009.

The mean age of the 17 GN patients was 39.2 years (range, 7-72; male:female ratio, 1:2.4), of whom 13 patients had unilateral GN on the right side, and the remaining 4 on the left side. None of the 17 tumors was hormonally active. Only 6 of the 17 GN cases were diagnosed as benign nerve cell tumors by computed tomography or magnetic resonance imaging before operation. Treatment consisted of open unilateral adrenalectomy in 9 patients and laparoscopy in 8 patients. The mean pathologic size of the adrenal GNs was 6.3 +/- 3.1 cm (range, 1.0-13.0). Ultrastructural examination provided additional support for confirming the diagnosis.

Although there have been some clues for radiologic diagnosis of adrenal GN, pre-operative mis- and maldiagnosis are not infrequent. We recommend that complete operative resection should be considered once malignancy cannot be excluded by pre-operative evaluation. Laparoscopic adrenalectomy is a reasonable option at least for tumors < or =7 cm.