Abstract:

Objective To analyze the clinical features of adrenal neurofibroma (ANF) and improve the understanding of its diagnosis and treatment techniques. Methods The clinical data, diagnosis and treatment process, and follow-up results of one pathologically confirmed ANF case admitted to our hospital were analyzed. Combined with published domestic and foreign literature review, case report was summarized. Results In this case, preoperative examination of relevant adrenal hormone levels was normal, and enhanced CT revealed a space occupying lesion in the right adrenal gland, indicating a benign neoplastic lesion. Posterior laparoscopic surgery was performed to remove the adrenal mass and a small portion of the right adrenal gland. Postoperative pathology showed a piece of grayish-yellow grayish-red tissue, with a size of 6.5 cm×5.5 cm×4.0 cm. The capsule was visible, with multiple nodular shapes on the section. The gray white solid was soft, the local nodules were hard, and a little adrenal tissue could be seen. Light microscopy showed spindle cell tumor, nerve fiber endings, and interstitial mucinous degeneration. No abnormal nuclear division or cell atypia was observed. Combined with immunohistochemistry, ANF was obtained. After one month of follow-up after operation, the levels of adrenal related hormones were normal, and there was no recurrence or metastasis. Conclusion ANF is a benign tumor with lack of specificity in clinical symptoms and signs. Preoperative laboratory and imaging examination cannot confirm the diagnosis, and the diagnosis depends on histopathology. Laparoscopic complete tumor resection is the key to treatment, and retroperitoneal approach has more advantages. Most of the cases have good prognosis, but close observation and follow-up are needed.

Key words: adrenal tumor, neurofibroma, peritoneoscopy, pathology