Manejo quirúrgico del quiste adrenal gigante: Reporte de caso y revisión de la literatura

Abstract

Objective: Present a giant adrenal cyst (AC) case treated with minimally invasive resection and to perform a narrative literature review available.

Material and Methods: A 54 year-old male presents with a left retroperitoneal slow growing mass, no symptoms, with a complex AC evidenced by previous images and mass biopsy, with suspected renal infiltration. A transabdominal laparoscopic resection is indicated.

Results: A complex hemorrhagic 9 cm diameter AC was found, with adhesions to left Gerota’s fascia. Complete resection of the AC was achieved through minimally invasive approach. The patient had an uneventful clinical recovery and was discharged on the second postoperative day. On 19th month of follow-up is completely asymptomatic. Even though the AC are benign lesions, the symptomatic giant AC, with fast growing ratio, and/or hemorrhagic conversion could be resected though laparoscopic adrenalectomy, with no increased morbidity or mortality.

Discussion: The laparoscopic approach for giant non-functional AC should be considered as the standard of care. More evidence is required in terms of surgical approach outcomes to define clear recommendations.

Conclusion: This report adds to the actual evidence in terms of minimally invasive approach for hemorrhagic giant AC.