Endocrine Abstracts

Incidentally discovered adrenal masses (adrenal incidentalomas) are found with increasing frequency due to the widespread use of imaging techniques of the abdomen. Most likely etiology of adrenal incidentaloma is benign non-functional adenoma. But there are rare causes like schwannoma and ganglioneuroma. During 2000 and 2013, we followed 248 adrenal incidentaloma cases that 38 of them operated. Here, we report two of them with the diagnosis of adrenal schwannoma and ganglioneuroma which thought to be rare causes.

Case 1: adrenal ganglioneuroma: A 18-year-old male with lower quadrant pain underwent an abdominal ultrasonography which revealed 5×7 cm left adrenal mass. A thorough investigation of this mass revealed it to be a non-functioning tumor. Magnetic resonance imaging (MRI) and ¹⁸F-2-fluorodeoxy-D-glucose-positron emission tomography (PET-CT) were also performed before surgery. The final pathology report revealed a ganglioneuroma.

Case 2: adrenal schwannoma: A 32-year-old woman with bloated feeling and stomach ache was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and PET-CT were also performed before surgery. Metabolic evaluation was unremarkable. Due to the large size of the tumor left adrenalectomy was performed. Histological examination established the diagnosis of schwannoma. This is the first schwannoma case with PET-CT imaging.

Conclusion: With increased and improved use of diagnostic imaging techniques it is predicted that the number of adrenal incidentalomas detected will continue to rise. Awareness of common and uncommon benign and malignant lesions of adrenal is vital for accurate pathological diagnosis to guide optimal patient management.