Adrenal ganglioneuromas: experience from a retrospective study in a Chinese population

Ganglioneuromas (GNs) are benign neoplasms of combined neural crest, schwannian,and connective tissue origin, occurring rarely in the adrenal glands. The present study is to share our experience regarding diagnostic and therapeutic management of these tumors.

Adrenal GNs of 15 patients were found incidentally with ultrasonography and were evaluated subsequently with computed tomography (CT) scan. Clinical data as well as follow-up data were collected retrospectively. All the patients received operative resection.

The mean age of the patients was 38.4 years (range, 25-52 years; male to female ratio, 2:1). Of study subjects 11 patients had unilateral GN on the right side, and the remaining 4 on the left side. All but 1 patient were asymptomatic. No hormonal secretion was apparent. Mean size of the tumors in CT scan was 6.27 cm (range, 2.5-14 cm), while 10 were larger than 5 cm. Eight patients underwent open adrenalectomy and the remaining 7 underwent laparoscopic anterior adrenalectomy. Histologically, all 15 neoplasms were completely differentiated,mature GN. We had no mortality or significant morbidity. Mean duration of hospitalization was 5.5 days (range, 3-7 days). There was no recurrence, during a mean followup of 5.4 years (range, 1-10 years).

Pre-operative diagnosis of adrenal GNs remains difficult merely according to physical examination. Therefore, we recommend complete operative resection once malignancy cannot be excluded by pre-operative analyses. Laparoscopic adrenalectomy is a reasonable option, at least for tumors ≤ 5 cm.