Successful Laparoscopic Removal of a Giant Left Adrenal Tumour

A 56-year-old female was examined for a chronic cough. During the workup, imaging studies surprisingly detected a large mass originating from the left adrenal gland. The tumour was much larger than those usually seen in day-to-day practice, measuring approximately 16 × 15 cm. Even with this mass size of the tumour, the patient’s hormonal assessment was found to be normal, which means that the tumour was non-functioning and did not secrete hormones from the adrenal glands.

The surgical team at Amrutha Hospital managed to remove the massive adrenal tumour through the laparoscopic adrenalectomy procedure. The thorough preoperative evaluation and structured surgical planning enabled the surgical team to manage this gigantic tumour through a complex surgery successfully.

Understanding Adrenal Tumours

The adrenal glands are small endocrine glands located above each kidney. They produce hormones that regulate blood pressure, metabolism, stress response, and electrolyte balance. Adrenal tumours may be discovered because they cause hormonal symptoms or, as in this case, completely by chance during imaging performed for an unrelated medical condition. Such lesions are commonly referred to as adrenal incidentalomas.

When an adrenal mass is detected, two important questions must be answered:

• Is the tumour producing excess hormones?
• Is there a possibility of cancer?

A complete hormonal workup and thorough imaging studies are important to plan the best treatment approach.

A Challenging Clinical Case

The patient had no symptoms suggestive of hormone overproduction, such as uncontrolled hypertension, unexplained weight gain, episodes of palpitations, or excessive sweating. Laboratory investigations confirmed a negative functional work-up, indicating a non-functioning tumour.

However, its unusually large size made doctors apprehensive about complications such as compression of adjacent structures, and even the possibility of its becoming cancerous. Upon careful consideration and discussions among experts from various medical disciplines, surgery was recommended.

Advanced Treatment with Laparoscopic Adrenalectomy

Traditionally, very large adrenal tumours were often managed through open surgery because of technical complexity. However, advances in minimally invasive surgery now allow carefully selected patients to benefit from laparoscopic techniques.

In this case, the surgical team at Amrutha Hospital completed a laparoscopic adrenalectomy, in which the entire adrenal gland, with the tumour present, was removed.

The procedure is complex and requires skill because the adrenal gland is close to blood vessels, the kidneys, the pancreas, the spleen, and other surrounding tissues. The surgery demands careful dissection and manipulation of blood vessels to remove the tumour without damage to the adjacent organs.

Excellent Postoperative Recovery

The surgery was completed successfully without major complications. The patient had an uncomplicated postoperative course. Mobilisation was initiated early after surgery; her pain management was good, and she was able to take oral feeds as per the advice of the operative team.

After being monitored for a few days following the operation, she recovered quickly and was discharged five days post-operation. The success of the case demonstrates the benefits of minimally invasive surgery when done by competent surgeons.

Benefits of Laparoscopic Adrenalectomy

Laparoscopic Adrenalectomy has some distinct advantages when compared to traditional open surgery:

• Small surgical wounds with better cosmetic effects
• Less post-surgical pain
• Decreased amount of blood loss during surgery
• Early ambulation
• Faster healing
• Shorter period of hospitalisation
• Faster resumption of routine daily activities

Not all adrenal tumours are amenable to laparoscopic surgery; however, with proper patient selection and surgical expertise, excellent results can be achieved.

Expertise at Amrutha Hospital

In this case, proper evaluation and planning of the procedure can play a major role, especially when the removal of large adrenal tumours is required. Before the procedure, extensive imaging and evaluation of hormone levels were performed to determine the best possible treatment. This made the surgery feasible and safe.

After the successful surgery, the patient recovered without any complications. The patient was then discharged from the hospital on the 5th postoperative day and was still doing well with regular follow-ups.

For every complex medical case, the expert surgical team at Amrutha Hospital follows an individualised approach. This successful outcome demonstrates that even large adrenal tumours can be safely removed using minimally invasive techniques with careful planning and surgical expertise.