Endocrine Abstracts

JOINT2637

Introduction: Ganglioneuroma is a rare, benign neurogenic tumor arising from sympathetic ganglion cells. It occurs mainly in the retroperitoneal region. Adrenal localization is rare. We report a case of adrenal ganglioneuroma in a 50-year-old man. The tumour was discovered incidentally on a thoracoabdominal CT scan ordered in the context of exploration for abdominal pain. The diagnosis was confirmed by pathological examination.

Observation: 53-year-old patient admitted for investigation of an adrenal mass. Clinically, no hypertension, no Menard’s triad and no signs of hypercorticism, with the exception of skin lesions suggestive of a hamartoma. Morphologically, abdominal CT revealed a left retroperitoneal mass, roughly oval, well limited, with regular contours, latero aortic on the left, heterogeneously enhanced after injection of contrast medium in relation to hypodense necrotic areas, measuring 110 *76mm in transverse diameter for 107mm in height. It displaces the pancreas anteriorly, making an imprint on the kidney and displacing it posteriorly, with no sign of invasion; it also displaces the spleen laterally, making intimate contact with the splenic vein anteriorly and the renal vein inferiorly; no vascular thrombosis. A CT scan focused on the adrenal glands or MRI could not be performed due to impaired renal function. Secretory work-up: Plasma methoxylates are negative. Minute braking with cortisol after braking 10ng/ml. Kalemia is normal Tumour markers are negative, as are LDH and b 2 microglobulin. A scan-guided biopsy was indicated and histological examination came back in favor of a ganglioneuroma. A meeting will be held with the urologists to decide on appropriate management.

Discussion: Ganglioneuroma is a rare benign tumor that deserves to be recognized and evoked in the presence of an adrenal mass discovered by chance. It is diagnosed histopathologically after an invasive procedure. However, as with all non-secretory incidentalomas, surgery should always follow an endocrine and radiological work-up. The possibility of local recurrence requires regular monitoring.

Bibliography: 2016 Pan African Urological Surgeons’ Association. Production and hosting by Elsevier B.V.