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Adrenalectomy for non-neuroblastic pathology in children

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Abstract

Background

Adrenalectomy for non-neuroblastic pathologies in children is rare with limited data on outcomes. We reviewed our experience of adrenalectomy in this unique population.

Methods

Retrospective study of children (age ≤ 18) who underwent adrenalectomy with non-neuroblastic pathology from 1988 to 2018. Clinical and operative details of patients were abstracted. Outcomes included length of stay and 30-day postoperative morbidity.

Results

Forty children underwent 50 adrenalectomies (12 right-sided, 18 left-sided, 10 bilateral). Six patients (15%) presented with an incidental adrenal mass while 4 (10%) had masses found on screening for genetic mutations or prior malignancy. The remaining 30 (75%) presented with symptoms of hormonal excess. Nineteen patients (48%) underwent genetic evaluation and 15 (38%) had genetic predispositions. Diagnoses included 9 patients (23%) with pheochromocytoma, 8 (20%) with adrenocortical adenoma, 8 (20%) with adrenocortical carcinoma, 7 (18%) with adrenal hyperplasia, 2 (5%) with metastasis, and 6 (14%) with additional benign pathologies. Of 50 adrenalectomies, twenty-five (50%) were laparoscopic. Median hospital length of stay was 3 days (range 0–11). Post-operative morbidity rate was 17% with the most severe complication being Clavien–Dindo grade II.

Conclusion

Adrenalectomy for non-neuroblastic pathology can be done with low morbidity. Its frequent association with genetic mutations and syndromes requires surgeons to have knowledge of appropriate pre-operative testing and post-operative surveillance.

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Funding

No funding was necessary for conduct of this study.

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Michael D. Traynor Jr., Alaa Sada, Geoffrey B. Thompson, David R. Farley, Benzon M. Dy, Melanie L. Lyden & Travis J. McKenzie

  2. Division of Pediatric Surgery, Mayo Clinic, Rochester, MN, USA

    Christopher R. Moir

  3. Division of Endocrinology, Mayo Clinic, Rochester, MN, USA

    Irina Bancos

  4. Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA

    Elizabeth B. Habermann

  5. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA

    Elizabeth B. Habermann

Authors
  1. Michael D. Traynor Jr.
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  2. Alaa Sada
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  3. Geoffrey B. Thompson
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  4. Christopher R. Moir
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  5. Irina Bancos
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  6. David R. Farley
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  7. Benzon M. Dy
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  8. Melanie L. Lyden
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  9. Elizabeth B. Habermann
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  10. Travis J. McKenzie
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Corresponding author

Correspondence to Travis J. McKenzie.

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All authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Mayo Clinic IRB.

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Traynor, M.D., Sada, A., Thompson, G.B. et al. Adrenalectomy for non-neuroblastic pathology in children. Pediatr Surg Int 36, 129–135 (2020). https://doi.org/10.1007/s00383-019-04589-9

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  • DOI: https://doi.org/10.1007/s00383-019-04589-9

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