Laparoscopic removal of large adrenal tumour in preteen girl

MADURAI

Gastroenterologists at Meenakshi Mission Hospital & Research Centre removed a big tumour of the adrenal gland, known as pheochromocytoma, from a 12-year-old girl.

The 14×10 cm tumor was removed with the minimally invasive surgery procedure called laparoscopic adrenalectomy. Laparoscopy is usually used for removing adrenal masses only if the growth is smaller than six cm and open adrenalectomy (the traditional surgery with large incision) is done on patients with pheochromocytoma measuring more than six cm.

In this patient, her obesity, the size of the tumour and its presence on the right adrenal gland made the 1.5-hour surgery distinctive, the doctors said.

“The patient’s age was a deciding factor for laparoscopy as it involved smaller scar, less discomfort and substantial benefits in terms of patient recovery,” said head of gastroenterology Ramesh Ardhanari, who led the team.

The patient from Tenkasi had reported with abdominal pain and during scanning for ovarian cyst was also diagnosed with right adrenal gland pheochromocytoma. “The irregular secretion of adrenalin and noradrenaline causes high blood pressure, palpitations and headache and it is not possible to perform any other surgery without removing the adrenal tumour first,” Dr. Ardhanari said.

He said this was a feat for his team consisting of senior gastroenterology consultants N. Mohan, Srinivasan Ramachandran, S. Jegadesh Chandra Bose, and senior anaesthetist N. Maharajan, because to the best of his knowledge, no one else in the world so far has removed right adrenal tumour of this size using laparoscopy.

The patient was discharged three weeks ago and was presented at a media briefing on Friday to show that she has made full recovery and resumed all normal activities.

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