Pediatric adrenal incidentaloma
Adrenal incidentalomas are a rare finding in children. In adults, adrenal incidentalomas are often found during imaging or postmortem. When incidentally discovered in adults, the principles of management focus on estimating risk of malignancy, with subsequent treatment plans developed accordingly. U...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-09-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576620302074 |
| _version_ | 1818578127306096640 |
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| author | Joyce J.L.H. McRae Andrei Radulescu Faraz A. Khan |
| author_facet | Joyce J.L.H. McRae Andrei Radulescu Faraz A. Khan |
| author_sort | Joyce J.L.H. McRae |
| collection | DOAJ |
| description | Adrenal incidentalomas are a rare finding in children. In adults, adrenal incidentalomas are often found during imaging or postmortem. When incidentally discovered in adults, the principles of management focus on estimating risk of malignancy, with subsequent treatment plans developed accordingly. Unfortunately, these guidelines are not applicable to children due to the difficulty in differentiating benign and malignant adrenal masses on imaging. For this reason, most pediatric adrenal masses are surgically excised. We present the case of a 14-year-old male who had imaging for nonspecific abdominal pain and was found to have a left-sided retroperitoneal mass suspicious for a retroperitoneal teratoma. Given the proximity to the adrenal gland, a hormonal workup was nonetheless performed with no evidence of abnormal hormonal activity noted. During laparoscopic intervention, this lesion was found to be originating from the adrenal gland raising suspicion for an adrenal mass and a laparoscopic left adrenalectomy was performed. Histology of the mass revealed a heterogenous mass with components concerning for adrenal cortical adenoma, myelolipoma and adrenocortical carcinoma. A more in-depth analysis of the mass using expert opinion revealed a diagnosis of adrenal cortical adenoma with hyaline myxoid stroma and secondary involutional features. |
| first_indexed | 2024-12-16T06:40:52Z |
| format | Article |
| id | doaj.art-efd63064e8c342899ec75540d365584d |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-12-16T06:40:52Z |
| publishDate | 2020-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-efd63064e8c342899ec75540d365584d2022-12-21T22:40:41ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662020-09-0160101573Pediatric adrenal incidentalomaJoyce J.L.H. McRae0Andrei Radulescu1Faraz A. Khan2School of Medicine, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92350, USASchool of Medicine, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92350, USA; Division of Pediatric Surgery, Loma Linda University Children's Hospital, 11175 Campus Street, Room 21111, Loma Linda, CA, 92350, USASchool of Medicine, Loma Linda University, 11175 Campus Street, Loma Linda, CA, 92350, USA; Division of Pediatric Surgery, Loma Linda University Children's Hospital, 11175 Campus Street, Room 21111, Loma Linda, CA, 92350, USA; Corresponding author. Loma Linda University Medical Center, 11175 Campus Street, CP21111, Division of Pediatric Surgery, Loma Linda University Children's Hospital, Loma Linda, CA, 92350, USA.Adrenal incidentalomas are a rare finding in children. In adults, adrenal incidentalomas are often found during imaging or postmortem. When incidentally discovered in adults, the principles of management focus on estimating risk of malignancy, with subsequent treatment plans developed accordingly. Unfortunately, these guidelines are not applicable to children due to the difficulty in differentiating benign and malignant adrenal masses on imaging. For this reason, most pediatric adrenal masses are surgically excised. We present the case of a 14-year-old male who had imaging for nonspecific abdominal pain and was found to have a left-sided retroperitoneal mass suspicious for a retroperitoneal teratoma. Given the proximity to the adrenal gland, a hormonal workup was nonetheless performed with no evidence of abnormal hormonal activity noted. During laparoscopic intervention, this lesion was found to be originating from the adrenal gland raising suspicion for an adrenal mass and a laparoscopic left adrenalectomy was performed. Histology of the mass revealed a heterogenous mass with components concerning for adrenal cortical adenoma, myelolipoma and adrenocortical carcinoma. A more in-depth analysis of the mass using expert opinion revealed a diagnosis of adrenal cortical adenoma with hyaline myxoid stroma and secondary involutional features.http://www.sciencedirect.com/science/article/pii/S2213576620302074Adrenal cortical adenomaMyelolipomaAdrenocortical carcinomaIncidentalomaPediatric |
| spellingShingle | Joyce J.L.H. McRae Andrei Radulescu Faraz A. Khan Pediatric adrenal incidentaloma Journal of Pediatric Surgery Case Reports Adrenal cortical adenoma Myelolipoma Adrenocortical carcinoma Incidentaloma Pediatric |
| title | Pediatric adrenal incidentaloma |
| title_full | Pediatric adrenal incidentaloma |
| title_fullStr | Pediatric adrenal incidentaloma |
| title_full_unstemmed | Pediatric adrenal incidentaloma |
| title_short | Pediatric adrenal incidentaloma |
| title_sort | pediatric adrenal incidentaloma |
| topic | Adrenal cortical adenoma Myelolipoma Adrenocortical carcinoma Incidentaloma Pediatric |
| url | http://www.sciencedirect.com/science/article/pii/S2213576620302074 |
| work_keys_str_mv | AT joycejlhmcrae pediatricadrenalincidentaloma AT andreiradulescu pediatricadrenalincidentaloma AT farazakhan pediatricadrenalincidentaloma |