Case Report: Retroperitoneoscopic Partial Adrenalectomy for Large Adrenocortical Oncocytoma

Introduction: Oncocytic neoplasms as tumors arising in the adrenal glands are rare, usually considered as nonfunctional and benign. In the current literature, there are extremely limited reports of adrenal oncocytic neoplasms; as to date, only 147 cases have been described. The rarity of the event prompted this study which reviews and presents the incidence, histology, diagnosis and therapy of adrenal oncocytic neoplasms. Materials and Methods: A review by systematic literature search was done using the MEDLINE®/Cochrane libraries from 1950 to date using the medical subject headings ‘oncocytoma', ‘adrenal gland', ‘adrenal oncocytoma', ‘adrenal oncocytic neoplasm' and ‘adrenal oncocytic carcinoma'. Results: Adrenal oncocytic neoplasm is a rare disease, usually incidentally detected because only 17% are functional adrenal masses. The typical oncocyte displays abundant granular eosinophilic cytoplasm, due to the accumulation of mitochondria. Computed tomography and magnetic resonance imaging are not able to identify or differentiate benign and malignant oncocytic neoplasms. The mainstay of therapy is adrenalectomy, recently performed by laparoscopy. The prognosis is good for benign tumors, while adrenocortical oncocytic carcinoma has a poor survival rate of only 5 years. Conclusions: Adrenal oncocytic neoplasm, a rare and mostly benign tumor, usually presents as an incidental, large adrenal mass; surgery is the mainstay of therapy, by means of laparoscopy which is now the most diffuse approach to adrenalectomy.

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“…Partial adrenalectomy is proposed in some case, however it is an incomplete approach to incidentally detected adrenal mass [94] .…”

Section: Therapymentioning

confidence: 99%

Adrenal Oncocytic Neoplasm: A Systematic Review

Mearini¹,

Sordo

Costantini³

et al. 2012

Urol Int

102

151

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“…In terms of location, AONs were found to have a slight prevalence on the left side (L/R: 1.4/1), which was lower than previously reported in the literature (L/R 3.5/1) [7]. In nine cases, the origin was ectopic, with four occurring in the retroperitoneal region [16,17,[19][20][21], and the others located at the posteroinferior region of the cecum [3], hepatic [14], renal [15], and lumbar spine [18].…”

Section: Discussionmentioning

confidence: 59%

“…AON patients presented a mean age at diagnosis of 44.2 years (range 3.5-87 years) and a female-tomale ratio of 1.9/1. AONs occurred with a slight prevalence on the left side (L/R: 1.4/1); in three cases (1.2%), they were bilateral [11][12][13], and in nine, the origin was ectopic [3,[14][15][16][17][18][19][20][21]. The masses had an average diameter of 8.9 cm (range 2-28 cm) and an average weight of 467 g (range 8-5720 g) [22,23].…”

Section: Resultsmentioning

confidence: 98%

Prognosis of Adrenal Oncocytic Neoplasms (AONs): Literature Review of 287 Cases and Presentation of the Oldest Patient

Coppola Bottazzi,

Gambardella,

Mongardini

et al. 2023

JCM

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Introduction: The adrenocortical oncocytic neoplasms (AONs) are rare tumors of the adrenal gland, classified as oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP) and oncocytic carcinoma (AOC). The aim of this study was to perform a review of the literature, in order to evaluate the prognosis of these rare cancers. We also reported the oldest patient with AON. Methods: A comprehensive literature review using as key words “adrenal oncocytoma”, “adrenal oncocytic neoplasm”, and “adrenal oncocytic carcinoma” was performed. Report of the case: We report the case of an 88-year-old woman receiving a left open adrenalectomy for an AON (15 × 10 × 8 cm). The considerable size and weight together with the presence of necrosis were indicative for a lesion with an uncertain potential for malignancy, according to Weiss modified criteria. After two years, the patient was free from any sign of recurrence. Results: Only 287 AONs were detected in the scientific literature, exploring OVID, MEDLINE, PubMed and SCOPUS as dataset. These tumors are usually incidentalomas with an unpredictable malignant potential. Surgical resection remains the mainstay of treatment for AON. Conclusion: AO and AONUMP have an excellent prognosis and a low mortality rate, with only three cases of recurrence reported in the literature and one metastatic case four years after first adrenal surgery. In contrast, AOC carries a high risk of local relapses, distant metastasis, and a significantly higher mortality rate (30%). Surgical resection remains the primary treatment for adrenal oncocytic neoplasms.

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“…In the literature, there are many reports of laparoscopic excision of adrenocortical oncocytomas; however, there are only five reports of laparoscopic excision of an adrenocortical oncocytoma ( Table 2). Modi et al reported the first partial laparoscopic adrenalectomy for retroperitoneal excision of a large adrenal oncocytoma in a young woman with mild hypertension in 2007 [8]. Subsequently, Tian et al reported retroperitoneal laparoscopic excision of an oncocytoma of the adrenal gland of a 37-year-old woman with no history of hypertension [9].…”

Section: Discussionmentioning

confidence: 99%

The first laparoscopic resection of an aldosterone-secreting adrenocortical oncocytoma in a child

Akın

Erginel

Tanık

et al. 2014

Journal of Pediatric Surgery Case Reports

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a b s t r a c tOncocytomas of the adrenal cortex are usually benign and nonfunctional, consisting of oncocytes in which the cytoplasm becomes eosinophilic due to the accumulation of abnormal mitochondria. Oncocytomas can exist in many organs and are frequently found in the salivary gland, kidneys, thyroid gland, parathyroid gland, and hypophysis. Functioning oncocytomas are very rarely observed in children, and no more than ten cases have been reported in the literature. Here, we present the first report of laparoscopic excision of an aldosterone-secreting adrenocortical oncocytoma in a child.

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Case Report: Retroperitoneoscopic Partial Adrenalectomy for Large Adrenocortical Oncocytoma

Abstract: A young woman had mild hypertension, and on evaluation, a large tumor arising from the right adrenal gland was found. The tumor was hormonally inactive. Retroperitoneoscopic partial adrenalectomy was carried out. The histopathology report described adrenocortical oncocytoma.

Cited by 9 publications

References 18 publications

Adrenal Oncocytic Neoplasm: A Systematic Review

Adrenal Oncocytic Neoplasm: A Systematic Review

Prognosis of Adrenal Oncocytic Neoplasms (AONs): Literature Review of 287 Cases and Presentation of the Oldest Patient

The first laparoscopic resection of an aldosterone-secreting adrenocortical oncocytoma in a child

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