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Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature

INTRODUCTION: Oncocytic adrenal neoplasms are rare and mostly benign lesions. Available literature supports indication for a surgical resection, but criteria to predict aggressive behavior are unreliable, thus making decision of surgical approach (laparotomy versus laparoscopy), and extent of resect...

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Autores principales: St-Amour, P., Djafarrian, R., Zingg, T., La Rosa, S., Demartines, N., Matter, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567174/
https://www.ncbi.nlm.nih.gov/pubmed/33068855
http://dx.doi.org/10.1016/j.ijscr.2020.09.185
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author St-Amour, P.
Djafarrian, R.
Zingg, T.
La Rosa, S.
Demartines, N.
Matter, M.
author_facet St-Amour, P.
Djafarrian, R.
Zingg, T.
La Rosa, S.
Demartines, N.
Matter, M.
author_sort St-Amour, P.
collection PubMed
description INTRODUCTION: Oncocytic adrenal neoplasms are rare and mostly benign lesions. Available literature supports indication for a surgical resection, but criteria to predict aggressive behavior are unreliable, thus making decision of surgical approach (laparotomy versus laparoscopy), and extent of resection, difficult to define. PRESENTATION OF CASE: This is the case of a 46-year-old male, with an incidental finding of a 10 cm asymptomatic tumor in the left adrenal gland identified by MRI, performed in the setting of the initial assessment of liver steatosis. Adrenal hormone levels were in the normal range, thus, a CT-guided needle biopsy was performed and showed an adrenocortical oncocytic neoplasm. A laparoscopic left adrenalectomy was performed sparing the adjacent left kidney. Histological examination of the resected tumor showed a 10 cm oncocytic adrenocortical neoplasm of uncertain malignant potential with negative resection margins. A follow-up MRI was scheduled at six months after surgery, and no recurrence was found. CONCLUSIONS: Although rare, oncocytic neoplasms should be included in the differential diagnosis of adrenal “incidentalomas”. Determination of their malignant potential is difficult in the preoperatory setting. Final diagnosis is based on histological analysis of the whole surgical specimen. Laparoscopic complete excision with negative resection margins is feasible and safe.
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spelling pubmed-75671742020-10-20 Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature St-Amour, P. Djafarrian, R. Zingg, T. La Rosa, S. Demartines, N. Matter, M. Int J Surg Case Rep Case Report INTRODUCTION: Oncocytic adrenal neoplasms are rare and mostly benign lesions. Available literature supports indication for a surgical resection, but criteria to predict aggressive behavior are unreliable, thus making decision of surgical approach (laparotomy versus laparoscopy), and extent of resection, difficult to define. PRESENTATION OF CASE: This is the case of a 46-year-old male, with an incidental finding of a 10 cm asymptomatic tumor in the left adrenal gland identified by MRI, performed in the setting of the initial assessment of liver steatosis. Adrenal hormone levels were in the normal range, thus, a CT-guided needle biopsy was performed and showed an adrenocortical oncocytic neoplasm. A laparoscopic left adrenalectomy was performed sparing the adjacent left kidney. Histological examination of the resected tumor showed a 10 cm oncocytic adrenocortical neoplasm of uncertain malignant potential with negative resection margins. A follow-up MRI was scheduled at six months after surgery, and no recurrence was found. CONCLUSIONS: Although rare, oncocytic neoplasms should be included in the differential diagnosis of adrenal “incidentalomas”. Determination of their malignant potential is difficult in the preoperatory setting. Final diagnosis is based on histological analysis of the whole surgical specimen. Laparoscopic complete excision with negative resection margins is feasible and safe. Elsevier 2020-09-29 /pmc/articles/PMC7567174/ /pubmed/33068855 http://dx.doi.org/10.1016/j.ijscr.2020.09.185 Text en © 2020 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
St-Amour, P.
Djafarrian, R.
Zingg, T.
La Rosa, S.
Demartines, N.
Matter, M.
Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature
title Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature
title_full Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature
title_fullStr Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature
title_full_unstemmed Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature
title_short Laparoscopic resection of an adrenal oncocytic neoplasm: Report of a case and review of the literature
title_sort laparoscopic resection of an adrenal oncocytic neoplasm: report of a case and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567174/
https://www.ncbi.nlm.nih.gov/pubmed/33068855
http://dx.doi.org/10.1016/j.ijscr.2020.09.185
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