ES21P LEFT LAPAROSCOPIC ADRENALECTOMY FOR A RARE CAVERNOUS HAEMANGIOMA

Abstract

Purpose: The adrenal gland is an extremely rare location for a cavernous haemangioma, and so far only 53 cases have been reported in the literature. Here, we present a rare case of a laparoscopically resected left adrenal haemangioma. Indication for resection of adrenal incidentalomas, laparoscopic technique, and unexpected histologies are discussed with review of the current literature.Methodology: Incidentally a 5 × 4 cm adrenal tumour was diagnosed in a 30 year old female patient. Preoperative imaging was performed and hormonactive tumours were ruled out. Laparoscopic left adrenalectomy was carried out using a transabdominal lateral flank approach. After mobilization of the spleen and rotation of the tail of the pancreas medially the adrenal vein was endoscopically clipped. Mobilization of all other borders was performed using the harmonic scalpel.Results: Time of surgery was 100 minutes. Histology revealed a rare case of adrenal cavernous haemangioma. Postoperative follow up after 6 months was normal.Conclusion: Despite comprehensive preoperative work‐up adrenal lesions may present with rare unexpected histologies, including neurogenic tumours, myelolipoma, metastases, adrenal carcinoma, or hemangioma. Adrenal hemangiomas possess a potential risk of haemorrhage, thrombosis and necrosis. Today, laparoscopic adrenalectomy is the safe and effective treatment of choice for benign tumours and isolated metastases. Operative time and complexity are reduced by using the harmonic scalpel. Incidentalomas larger than 4 cm should be resected laparoscopically if no adrenal carcinoma is suspected.