Laparoscopic Approach to a Unilateral Adrenal Cyst in a Pediatric Patient

Christoph Castellani, MD, Georg Singer, MD, Manfred Ratschek, MD, Erich Sorantin, MD, Florian Friedmacher, MD, Holger Till, MD

Department of Pediatric and Adolescent Surgery (Drs Castellani, Singer, Friedmacher, Till), Department of Pathology (Dr Ratschek), Department of Radiology (Dr Sorantin), Medical University Graz, Graz, Austria.

ABSTRACT

Introduction: Adrenal cysts are rare findings, with an age peak between the third and fifth decades of life. In adults, laparoscopic and retroperitoneoscopic approaches to these cysts have been described. In pediatric patients, however, reports of this pathology and its management are limited to a small number of case reports.

Case Report: A cystic mass was discovered in the left upper abdominal quadrant of a 12-year-old female patient during the diagnostic workup because of chronic back pain. Blood chemistry, parasitology, and tumor markers were negative, and the patient was scheduled for laparoscopy. Intraoperatively, the cyst was found to originate from the left adrenal gland. Firm attachments between the cyst and the adrenal gland required partial adrenalectomy. The operation and the postoperative course were uneventful, and the patient was discharged on the sixth postoperative day. The histologic workup revealed a true endothelial cyst of the adrenal gland.

Discussion: In the described case, laparoscopy was found to be a safe and feasible approach allowing definitive localization of the pathology and therapy within the same session.

Key Words: Laparoscopy, Adrenal cyst, Children, Abdominal cyst

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