Adrenal masses in children: Imaging, surgical treatment and outcome

• Published in: Asian journal of surgery 2020-01, Vol.43 (1), p.207-212
• Main Authors: Emre, Şenol, Özcan, Rahşan, Bakır, Ayten Ceren, Kuruğoğlu, Sebuh, Çomunoğlu, Nil, Şen, Hilal Susam, Celkan, Tiraje, Tekant, Gonca Topuzlu
• Format: Article
• Language: English
• Subjects: Adrenal cysts; Adrenal mass; Image defined risk factors; Neuroblastoma; Pheochromocytoma
• ISSN: 1015-9584
• DOI: 10.1016/j.asjsur.2019.03.012

This study aims to evaluate the current surgical approach to adrenal masses in the pediatric age group. We retrospectively analyzed cases that underwent surgery for adrenal masses between 2007 and 2017. Patients were assessed regarding age, sex, primary diagnosis, image defined risk factors (IDRF), surgical treatment method, complications, duration of hospital stay, and follow-up. We examined 50 patients who underwent surgery for adrenal mass (mean age: 4.8 years; range: 5 days–14 years). For IDRF assessment, Ultrasonography was used in 42, Computed Tomography in 36, and Magnetic Resonance Imaging in 36 patients. Lesions were present on the right in 25, left in 21, and bilateral in 4 patients. Histopathological findings were neuroblastoma (n = 29), ganglioneuroma (n = 6), adrenal cortex tumor (n = 5), ganglioneuroblastoma (n = 4), pheochromocytoma (n = 3), cyst (n = 1), and adrenal hematoma (n = 2). Laparotomy was performed on 37 patients, and laparoscopy on 13 patients. None of the cases had any operative complications. The crucial factors determining the surgical approach to adrenal masses in pediatric cases are the histopathology of the mass, volume, and IDRF. Minimally invasive procedures could be reliably performed in appropriate cases.