Clinical characteristics and management of adrenal ganglioneuroma: a single center retrospective study.
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BACKGROUND: To improve the clinical diagnosis and safety of surgical treatment of adrenal ganglioneuroma (AGN), we present the experience regarding the diagnostic and therapeutic management of tumors. METHODS: From January 2013 to September 2025, we retrospectively reviewed demographic, clinical, biochemical, radiologic, surgical, and pathological findings, as well as the follow-up of AGN patients who underwent adrenal surgery at a tertiary referral center in eastern China. RESULTS: We included 84 patients with AGN. The median age was 34.5 years, and 73.8% cases were asymptomatic. Preoperatively, endocrine abnormalities were identified in 21.4% of patients, including some clinically asymptomatic individuals, whereas AGN was suspected on imaging in only 29.8% of cases. Compared to the tumor diameter < 4 cm group, the ≥ 4 cm group had longer operative time (median 90.0 versus 60.0 min, P = 0.004), greater intraoperative blood loss (median 20.0 versus 10.0 mL, P < 0.001), and longer total length of stay (median 12.0 versus 8.0 days, P = 0.035). Laparoscopic subgroup analysis revealed a significant interaction: partial adrenalectomy was associated with shorter postoperative length of stay for tumors < 4 cm (P < 0.001; interaction P = 0.014), whereas total adrenalectomy was associated with less blood loss for tumors ≥ 4 cm (P = 0.030; interaction P = 0.019). No recurrence was observed among 55 patients with available follow-up, although the median follow-up duration was limited to 3 months. CONCLUSIONS: Most AGNs are incidental and nonfunctional, and imaging is non-specific. Preoperative biochemical screening is essential to exclude hormone excess. Laparoscopic surgery is safe and effective, with laparoscopic partial adrenalectomy favored for tumors under 4 cm and laparoscopic adrenalectomy preferred for larger lesions.