Nosological verification of adrenal incidentaloma. differential diagnosis between ganglioneuroma and adrenocortiocal cancer: a clinical case

Ganglioneuromas (GN) are rare benign neoplasms originating from neural crest tissue. These tumors are typically asymptomatic and are often detected incidentally during diagnostic imaging studies. Although the radiological characteristics of adrenal GNs are relatively well-studied, establishing an accurate diagnosis still remains a challenging task. Currently, the definitive diagnosis is established based on the morphological examination of postoperative material. This publication presents a rare clinical case of an adrenal GN identified in a 35-year-old male. А mass in the right adrenal gland measuring 8.4×5.8×5.8 cm with a malignant CT phenotype and indirect signs of possible invasion was detected at an abdominal MSCT scan. Hormonal evaluation showed no evidence of excessive hormone secretion. Taking into account the set of characteristics of the tumor, which indicated a high risk of malignancy, the patient underwent surgical treatment, including thoracophrenolaparotomy and right adrenalectomy. Morphological examination revealed that the tumor consisted of interwoven bundles of mature Schwann cells with ganglion cell inclusions confirming the diagnosis of GN. The postoperative period was uneventful. This clinical case highlights the difficulty in preoperative diagnosis of GN and underscores the need for comprehensive and thorough evaluation using all available diagnostic methods.