38. ULUSAL ÇOCUK CERRAHİSİ KONGRESİ, Antalya, Türkiye, 25 Kasım 2021, ss.346-347, (Özet Bildiri)
Introduction: Laparoscopic excision of left adrenal mass, especially if it is regressive after chemotherapy, might
be challanging. We present here two cases with left adrenal neuroblastoma totally excised by laparoscopy, one
metastatic significantly regressed after chemotherapy and together with a local metastatic lesion and the other
primary lesion.
Case 1: Nine month old girl was admitted multi-metastatic (including CNS) left adrenal neuroblastoma. After
chemotherapy, MIBG showed regression of metastasi and a residuel left adrenal mass with 2x1x1 cm diameters,
as well as a local metastasis. According to the tumor council, the left adrenal mass is laparoscopically excised. The
position for laparoscopy was semilateral/lateral. Four trochars were used. The left adrenal gland was dissected by
Ligasure and monopolar cautery. An incisional biopsy was performed on the mass at the renal hilus.
Histopathologic examination of the adrenal gland revealed a mature ganglioneuroma transformation and normal
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renal tissue was found at the mass of renal hilum. The patient receive treatment for metastasi and a bone marrow
transplantation is planning.
Case 2: One and half year old boy was admitted left adrenal mass. According to the tumor council, the left adrenal
mass is laparoscopically excised. The position for laparoscopy was semilateral/lateral. Four trochars were used.
The left adrenal gland was dissected by Ligasure and monopolar cautery. Histopathologic examination of the
adrenal gland revealed a neuroblastoma. MIBG and other imaging studies showed no other location. According to
tumor markers neuroblastoma is favorable and no further treatment is indicated.
Conclusion: Left adrenal gland excision for metastatic neuroblastoma is possible, safe and effective by an
ergonomically well planned laparoscopy.