Diagnosis and therapy of adrenal ganglioneuromas / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the clinical characteristics,manifestation and management of adrenal ganglioneuromas. Methods The data of 15 cases of ganglioneuromas diagnosed by pathology were reviewed retrospectively.Of the 15 cases,5 was male,aged 24 to 45 with an average of 29 years,and other 10 was female,aged 25 to 69 with an average of 31.Ten tumors were located in the right side,which was twice as many as that of the left side.There were 8 patients discovered by B ultrasonograpgy during health check-up,4 patients were detected because of paroxysmal abdominal pain. Three cases mainly presented with paroxysmally hypertension,and one of them had a high level of aldosterone ( 112 pmol/L). One of them had a high level of epinephrine (210 nmol) and nor-epinephrine (496 nmol). The B-ultrasound showed low-echo in all cases.Five cases showed calcification,the border was legible.The border lines of the tumors are not clear with vana cava in two cases. On unenhanced CT scanning,all cases showed low density areas.Eleven of the 15 cases underwent the enhanced CT,but 10 cases showed no enhanced areas on CT scanning.One case underwent MRI and showed low signals in T1 WI and inhomogeneous high signals in T2WI. Results Twelve cases underwent adrenal glands tumorectomy with abdominal NO.11 intercostals incision while other 3 underwent adrenal glands tumorectomy through posterior abdominal laparoscope.The tumors were completely removed in 14 cases,partly removed in 1 case.All patients recovered soon without complications such as bleeding or adrenal crisis.All cases were followed-up 13 to 74 months.The blood pressure of 3 cases with hypertension decreased to normal.The tumors recurred in 1 case,but no metastasis 55 months later. Conclusions It is difficult to differentiate adrenal medullary tumor from ganglioneuromas.The imaging data of iconography before surgery can give helpful information in the diagnosis of ganglioneuroma.Complete surgical excision is the only method for curing and the outcome is satisfactory.