Case report: Large adrenal ganglioneuroma

INTRODUCTION: Ganglioneuromas are localized tumors derived from neural crest tissues. Characteristically, they originate in the posterior mediastinum. Pure adrenal gangliomas are extremely rare. PRESENTATION OF CASE: A left adrenal mass with the size of 68 mm x 50 mm x 86 mm on magnetic resonance imaging was documented in a 53-year-old female patient. Endocrine tests revealed a non-functioning adrenal mass. The actual size of the mass was macroscopically measured to be 16 cm x 8.5 cm x 6 cm after the surgery. Histopathological examination indicated ganglioneuroma. DISCUSSION: Most adrenal ganglioneuromas can incorrectly be diagnosed as other adrenal tumors, since they are rare neurogenic benign tumors with no specific imaging properties. They have a slow growth pattern and usually asymptomatic. Our case represents a huge adrenal ganglioneuroma in a female patient with nondiagnostic flank pain. Radiological imaging showed a large adrenal mass with no differentiation from other adrenal tumors. Endocrine evaluation should be performed for such adrenal masses. Since our case had a relatively large size, open surgery was preferred. Pathology revealed the definitive diagnosis. CONCLUSION: This case suggests that ganglioneuromas can wrongly be diagnosed as other adrenal tumors. It is significant that a proper differential diagnosis should be performed by using hormonal and imaging techniques. Nevertheless, pathological examination is usually required for definitive diagnosis. (C) 2014 The Authors. Published by Elsevier Ltd.