Adrenal ganglioneuroma in an adolescent presenting as an incidentaloma: Imaging-pathology correlation and diagnostic challenges: A case report.
Wasef Alhroub, Omair Bseiso, Mohammad Manasra et al.
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Case in brief
A previously healthy 16-year-old male had a right adrenal mass discovered incidentally on CT after a bicycle accident. CT and MRI showed a well-circumscribed lesion with progressive enhancement and no washout or intralesional fat; biochemical testing found no hormonal hypersecretion. Because the mass was large and imaging remained indeterminate, he underwent right adrenalectomy. Histopathology confirmed adrenal ganglioneuroma. Recovery was uneventful. Transient blood-pressure elevation during follow-up led to repeat biochemical testing, which showed no catecholamine excess; CT at 9 months showed no recurrence.
What made this case unusual
The lesion was found incidentally in an adolescent and showed progressive, persistent enhancement without washout, an imaging pattern that suggested a neurogenic tumor but did not establish the diagnosis.
Diagnostic / clinical pearl
Progressive delayed enhancement without washout and absence of signal loss on opposed-phase MRI may suggest adrenal ganglioneuroma, but imaging is not definitive; histopathology confirmed the diagnosis in this case.