Diagnosis and surgical treatment of adrenal ganglioneuroma: a retrospective cohort study of 51 patients in a single center

Objectives: To analyze the clinical features, imaging findings, and surgical results of 51 cases of adrenal ganglioneuroma (AGN) in our center to provide a clinical reference for its diagnosis and treatment. Methods: We retrospectively reviewed the clinical data of 51 AGN patients admitted to our hospital. We summarized the clinical and imaging characteristics and analyzed the effects of different surgical methods and tumor size on the perioperative outcome. Results: The mean tumor size was 6.1 +/- 2.4 cm. The mean computerized tomography (CT) value of tumors on the plain scan images was 29.9 +/- 4.3 Hounsfield units (HU), and 60.8% (20/45) of tumors showed delayed progressive enhancement on enhanced CT images. Pathologically, immunohistochemistry revealed a positive rate of 91.7% for S-100 (11/12) and 77.8% (7/9) for Vimentin. Of the 51 patients, 32 underwent laparoscopic adrenalectomy, and 19 underwent open adrenalectomy. The median postoperative follow-up time was 51.1 (2-125) months, and no tumor recurrence or metastasis occurred during the follow-up. The estimated blood loss (EBL) was reduced in the laparoscopic group compared to the open group (P=0.027). Larger tumors prolonged the operation time and postoperative hospital stay (both P < 0.05). Conclusions: This study reports the largest series of AGN patients to date. CT plays a guiding role in the preoperative diagnosis of AGN, but the pathologic results are the most reliable. Laparoscopic adrenalectomy may be safer than open surgery. Larger tumor volume is a risk factor for a longer operative time and postoperative hospital stay.