Laparoscopic removal of a giant adrenal hemangioma

Alexandra Argiroff, MD, Scott Nguyen, MD. Icahn School of Medicine at Mount Sinai Hospital

Laparoscopic adrenalectomy has long been accepted as an acceptable way to remove adrenal masses. Most tumors excised are small functional tumors, or masses larger than four to six centimeters.

We present the case of a 67-year-old male with a 13.5 centimeter non-functioning adrenal tumor. He presented initially with incidental elevated liver function tests on routine labs. His workup revealed a 13.5cm heterogenous cavernous right adrenal mass. Extensive endocrine workup did not find a functional adrenal tumor. 

He was taken to the operating room for a laparoscopic adrenalectomy. The case was uneventful, and he did well post-operatively. He was discharged home on post-operative day four with minimal pain.

The final pathology showed that it was a 13 centimeter adrenal hemangioma with an intact capsule. 

The average size of adrenal masses removed with laparoscopic surgery is about seven centimeters. The tumor removed in this case was almost double the average size excised in this fashion. Giant adrenal masses can safely be removed with laparoscopic surgery.