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Treatment of the Perinatally Diagnosed Asymptomatic Adrenal Gland Mass

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~O~2PL~ : A·l\ 1 0 ~ All 2 ~ 2004iJ

107 Vol. 10, No, 2, December 2004

Treatment of the Perinatally Diagnosed Asymptomatic Adrenal Gland Mass

Seung Hyun Hwang, M.D., Jun Sup Lim, M.D., Jung-Tak Oh, M.D., Myung Joon Kim*, M.D., Seok Joo Han, M.D., Seung Hoon Choi, M.D.

Division of Pediatric Surgery, Department of Surgery and Department of Diagnostic Radiology*

Yonsei University College of Medicine, Seoul, Korea

Recently, the incidence of perinatally detected asymptomatic adrenal gland masses has increased because of widespread use of radiological diagnostic tools.

However, optimal treatment of these masses has not been determined. The aim of this study is to elucidate the treatment guideline of perinatally diagnosed adrenal gland masses. The authors retrospectively reviewed the medical records of the 11 patients with asymptomatic adrenal gland mass, detected perinatally, between 1999 and 2004. Six cases were detected by prenatal ultrasound and 5 cases were incidentally detected by postnatal ultrasound. Six patients (surgery group) underwent mass excision. The pathologic diagnoses were neuroblastoma (n =4), adrenocortical adenoma (n =

1)

and adrenal pseudocyst (n =

1).

The indications for operation were suspicion of neuroblastoma (n=5) or absence of size decrease during observation (n = 1). Three of the 5 suspicious cases of neuroblastoma and one case under observation were proven to be neuroblastoma. There was no surgical complication in the urgery group. All neuroblastoma patients have been well during the follow up period (24.4±14.4 month) without evidence of recu- rrence. Five cases (observation group) were closely observed because of the benign possibility or size decrease in follow up ultrasound. During the observation period (39±21 week), 4 cases showed complete spontaneous resolution and 1 case showed markedly decreased size of the mass but could not be followed up completely. Surgical resection of the perina tally diagnosed asymptomatic adrenal gland mass is a safe treatment method especially in case of suspicion of neuroblastoma, but closed observation can be applied.

(J

Kor Assoc Pecliatr Surg 10(2):107-111), 2004.

Index Words: Adrenal gland, Mass, Pennatal diagnosis

Correspondenee : Jung-Tak Oh, M.D., Division of Pediatric Sur- gery, Department of Surgery, Yonsei University College of Medi- cine. #134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea

Tel: 02)361-5593 Fax: 02)313-8289 E-mail: jtoh@ymnc.yonsei.ac.kr

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Table 1. Clinical Data and Outcome of the Perinatally Diagnosed Asymptomatic Adrenal Gland Mass Time of Initial Size of Initial Age at Observation Case Sex

diagnosis Diagnosis Tumor (cm) Treatment operation (d) period (wk) Final result

F Prenatal Malignancy 4.5 Excision 43 NA Neuroblastoma

2 M Postnatal Malignancy 4.2 Excision 167 NA Neuroblastoma

3 M Prenatal Malignancy 5.7 Excision 20 NA Cortical adenoma

4 M Prenatal Malignancy 5.0 Excision 4 NA Neuroblastoma

5 M Prenatal Malignancy 3.6 Excision 13 NA Adrenal pseudocyst

6 M Prenatal Benign 1.4 Observation 78 7.7 Neuroblastoma

7 M Postnatal Benign NA

8 M Postnatal Benign NA

9 M Postnatal Benign 2.3

10 M Prenatal Benign 2.7

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NA; not available

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Observation of untreated patients with neuroblastoma detected by mass screening: a "wait and see" pilot study. Med Pediatr Oncol 36: 160-162, 2001

13. Bessho F, Hashizume K, Nakajo T, Kamoshita S:

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111

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21. Petit T, de Lagausie P, El Ghoneimi A, Garel C, Aigrain Y: Postnatal management of cystic neuro- blastoma. Eur J Pediatr Surg 11:411-414, 2001

수치

Table  1.  Clinical  Data  and  Outcome  of  the  Perinatally  Diagnosed  Asymptomatic  Adrenal  Gland  Mass  Time  of  Initial  Size  of  Initial  Age  at  Observation  Case  Sex

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