ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 65 P23 | DOI: 10.1530/endoabs.65.P23

Non-adrenal tumours encountered during adrenal surgery

Radu Mihai

Churchill Cancer Centre, Oxford, United Kingdom

Background: Benign cortical and medullary tumours, adrenocortical cancers (ACC), bilateral adrenal hyperplasia, adrenomyelolipomas and metastases are commonly discussed in the differential diagnosis of a tumour in the adrenal bed. This study reports a series of non-adrenal tumours encountered during surgery for expected adrenal tumours.

Method: Retrospective review of surgical practice in a tertiary referral centre.

Results: Between 2014 and 2018 the annual workload for adrenal surgery ranged 60–75. In this large cohort of over 300 patients, a small minority of patients (n=15) had unexpected histological diagnoses. Eight patients with median age 29 years had ganglioneuromas (5R:1L). Five patients with median age 75 years had large retroperitoneal schwanomas initially suspected to be ACC based on PET activity (3R:2L). Two patients age 58 years old with left-sided tumours had a GIST (gastrointestinal stromal tumour) measuring 55 and 150 mm. A 12-cm left adrenal teratoma was excised in a 27 years old woman, a bronchogenic cyst and a hemangioma were diagnosed as left-sided phaeochromocytomas based on mild biochemical abnormalities and positive MIBG uptake.

Conclusion: Retroperitoneal tumours should be considered in the differential diagnosis of non-functional large (adrenal) mass. Ganglioneuromas were more common in younger patients and schwannomas in older patients. Functional imaging with C11-metomidate might become a useful adjunct in differentiating cortical adrenal tumours from other retroperitoneal tumours.

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