A 50-year-old male patient, with no personal or family history of interest, consulted for an external diameter of urology on abdominal ultrasound, performed for nonspecific digestive symptoms, of a 6 cm solid right adrenal tumor.
Anamnesis and physical examination revealed no symptoms or signs suggestive of endocrine disease or the presence of a primary tumor.
Endocrinological study was carried out to establish the functioning or not of the adrenal tumor.
Urine cortisol; 24-hour urine cortisol; 1 mg dexamethasone; baseline cortisol in blood; aldosterone; aldosterone in urine with dexamethasone (TCA), urinary cortisol and nephrotic metabolites were measured.
The results of the analytical parameters were all normal.
Abdominal CT demonstrates the presence of a solid right adrenal mass, with well-defined and heterogeneous contours, with areas of low density and calcium density in its interior, measuring 6.5 x 3 cm.
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The study concluded the presence of a solid right adrenal mass, 6.5 cm in diameter and non-functioning.
With this diagnosis, and based mainly on the size of the tumor, as well as the presence of irregular calcifications within it, it was decided to surgically remove it in the presence of an adrenal carcinoma.
Right adrenalectomy was performed through lumbotomy.
Macroscopically, the deectomy specimen measured 8 x 6.5 x 3 cm. The tumor showed a multinodular surface, consisting of a homogeneous, fasciculated suprarenal white tissue.
Microscopically, the tumor consists of Schwann cells arranged in small intertwined fascicles with the presence of foci of myxoid stroma and groups of mature ganglion cells.
Immunohistochemical study was carried out to determine the intense and generalized protein S-100 immunoreaction in cells.
The definitive diagnosis is adrenal ganglioneuroma.
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After 2 years of follow-up the patient is asymptomatic and there is no evidence of recurrence of the lesion.
