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Adrenalectomy for non-neuroblastic pathology in children

  • Michael D. TraynorJr.
  • Alaa Sada
  • Geoffrey B. Thompson
  • Christopher R. Moir
  • Irina Bancos
  • David R. Farley
  • Benzon M. Dy
  • Melanie L. Lyden
  • Elizabeth B. Habermann
  • Travis J. McKenzieEmail author
Original Article
  • 15 Downloads

Abstract

Background

Adrenalectomy for non-neuroblastic pathologies in children is rare with limited data on outcomes. We reviewed our experience of adrenalectomy in this unique population.

Methods

Retrospective study of children (age ≤ 18) who underwent adrenalectomy with non-neuroblastic pathology from 1988 to 2018. Clinical and operative details of patients were abstracted. Outcomes included length of stay and 30-day postoperative morbidity.

Results

Forty children underwent 50 adrenalectomies (12 right-sided, 18 left-sided, 10 bilateral). Six patients (15%) presented with an incidental adrenal mass while 4 (10%) had masses found on screening for genetic mutations or prior malignancy. The remaining 30 (75%) presented with symptoms of hormonal excess. Nineteen patients (48%) underwent genetic evaluation and 15 (38%) had genetic predispositions. Diagnoses included 9 patients (23%) with pheochromocytoma, 8 (20%) with adrenocortical adenoma, 8 (20%) with adrenocortical carcinoma, 7 (18%) with adrenal hyperplasia, 2 (5%) with metastasis, and 6 (14%) with additional benign pathologies. Of 50 adrenalectomies, twenty-five (50%) were laparoscopic. Median hospital length of stay was 3 days (range 0–11). Post-operative morbidity rate was 17% with the most severe complication being Clavien–Dindo grade II.

Conclusion

Adrenalectomy for non-neuroblastic pathology can be done with low morbidity. Its frequent association with genetic mutations and syndromes requires surgeons to have knowledge of appropriate pre-operative testing and post-operative surveillance.

Keywords

Pediatric adrenalectomy Laparoscopic adrenalectomy Adrenocortical carcinoma Pheochromocytoma Endocrine Primary pigmented nodular adrenocortical disease (PPNAD) 

Notes

Funding

No funding was necessary for conduct of this study.

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Mayo Clinic IRB.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Michael D. TraynorJr.
    • 1
  • Alaa Sada
    • 1
  • Geoffrey B. Thompson
    • 1
  • Christopher R. Moir
    • 2
  • Irina Bancos
    • 3
  • David R. Farley
    • 1
  • Benzon M. Dy
    • 1
  • Melanie L. Lyden
    • 1
  • Elizabeth B. Habermann
    • 4
    • 5
  • Travis J. McKenzie
    • 1
    Email author
  1. 1.Department of SurgeryMayo ClinicRochesterUSA
  2. 2.Division of Pediatric SurgeryMayo ClinicRochesterUSA
  3. 3.Division of EndocrinologyMayo ClinicRochesterUSA
  4. 4.Division of Health Care Policy and ResearchMayo ClinicRochesterUSA
  5. 5.Robert D. and Patricia E. Kern Center for the Science of Health Care DeliveryMayo ClinicRochesterUSA

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