Mature ganglioneuroma of the adrenal gland as a new rare cause of visible haematuria: A case report & literature review

INTRODUCTION: Ganglioneuromas are benign tumours of the sympathetic ganglia and the adrenal glands medulla. We describe a case of a fit and well 18 year old Caucasian male patient who initially presented to primary care with intermittent episodes of painless frank haematuria as well as some non-specific right-sided loin pain. PRESENTATION OF CASE: In this 18 year old man, initial ultrasound investigations at a ‘one stop haematuria’ clinic revealed the presence of an echogenic solid mass of 120 × 110 × 90 mm around the upper pole of the right kidney. A CT scan of the abdomen proved inconclusive to further determine the aetiology of the mass. Following a local multidisciplinary meeting (MDT) an MRI of the abdomen was undertaken which confirmed the presence of a large right adrenal mass. A biopsy was taken to determine the histology of the mass confirming a mature ganglioneuroma. The patient subsequently underwent surgery within 6 weeks of having presented to his general practitioner. CONCLUSION AND DISCUSSION: The surgery was uncomplicated and excision of the mass was made via a thoraco-abdominal approach. The patient recovered well post operatively and was discharged home within 8 days with outpatient follow-ups organised.