Minimally Invasive Surgery for Pediatric Adrenal Masses—Report on Four Cases

Author:

ElHaddad Ahmed1,Castellani Christoph1,Sorantin Erich2,Benesch Martin3,Kampelmühler Eva4,Singer Georg1,Till Holger1

Affiliation:

1. Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria

2. Department of Radiology, Division of Pediatric Radiology, Medical University of Graz, Graz, Styria, Austria

3. Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria

4. Institute of Pathology, Medical University of Graz, Graz, Austria

Abstract

AbstractThe dignity of adrenal masses in children varies from benign lesions like adenoma and ganglioneuroma to malignant tumors like adrenocortical carcinoma and neuroblastoma. Any surgical approach, especially minimally invasive surgery (MIS), requires careful risk stratification based on oncological and technical criteria. Herein, we present four patients who underwent MIS for adrenal masses. Laboratory testing differentiated between simple cysts and adenoma, but could not identify a child with adrenocortical tumor preoperatively. Analysis of image-defined risk factors excluded vascular encasement in all cases. All patients underwent laparoscopic adrenalectomy without complications. Histopathology revealed simple cyst, ganglioneuroblastoma, adenoma, and potentially malignant adrenocortical tumor in one patient/case each. All specimen showed clear margins and no recurrence was noted at a mean follow-up of 18 months.

Publisher

Georg Thieme Verlag KG

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