Ganglioneuroma, una entidad a considerar en las masas adrenales incidentales. Revisión de la literatura y reporte del primer caso de extracción completamente laparoscópica en México

INTRODUCTION Ganglioneuromas are rare tumors that arise from the neural crest tissue, characterized by benign behavior and slow growth, located most frequently in the posterior mediastinum and rarely in the adrenal gland. Its diagnosis is generally incidental and asymptomatic. CASE REPORT A 56-year-old male, asymptomatic, who comes to assessment due to the finding of incidental adrenal mass in simple tomography, requested due to microscopic hematuria. Contrast tomography was performed, finding a left adrenal tumor of 4 cm diameter, with enhanced attenuation less than 20 HU. Metabolites of catecholamines in urine and blood within normal parameters. A laparoscopic adrenalectomy was performed. The histopathological study corresponds to adrenal Ganglioneuroma. DISCUSSION The diagnosis of adrenal ganglioneuroma represents a diagnostic challenge, due to its silent clinical presentation, some authors suggest that the findings in contrast-enhanced tomography of a metabolically nonfunctioning adrenal mass with unenhanced attenuation less than 40 HU, and the presence of punctiform calcifications should suggest ganglioneuroma, however the differentiation between neural crest tumors is histopathological. In the presence of an adrenal mass bigger than 4 cm, regardless of its behavior and clinical characteristics, surgical management is indicated, as it corresponds to the most appropriate diagnostic and treatment method.