Background : Diagnosis and treatment strategy for adrenal tumors is challenging due to low incidence and different clinical presentations such as virilization, hyperestrogenism; Cushing’s syndrome; hypertension, flushing.
Minimal access surgery (MAS) for adrenal tumors in pediatric population is still controversial and literature is mostly focused in the "open" procedures. Data is mainly published as single case reports or case series. However management is changing as pediatric oncologists (e.g. SIOP, COG, GPOH) integrating MAS for selective tumors, including adrenal tumors, into treatment concepts.
We are presenting our experience with children who underwent MAS resection for selected adrenal tumors.
Methods: Retrospective review of 6 consecutive patients with adrenal tumor, who underwent after preoperative investigation and preparation complete tumor excision by MAS in 2015-2018. Different imaging modalities - CT and MRI, had equal input in decision making process.
Results: All patients underwent laparoscopic resection. The median age was 11.7 years. Tumor size ranged from 1.8 to 3.7 cm maximum diameter. No conversions or intra operative complications. The mean hospital stay was 2.8 days - related mostly to IV analgesia. Final diagnoses included: Adenoma (n = 2), Pheochromocytoma (n = 3), Ganglioneuroma (n=1). No recurrence was detected in relatively short mean follow-up of 1.6 y.
Conclusions: MAS for adrenal tumor resection can be performed safely in selected pediatric patients with excellent outcomes in terms of minimal discomfort, rapid recovery and excellent cosmesis.
Studies with larger volume of patients and longer follow up are required to adequately assess recurrence rate.
