Laparoscopic surgery in great adrenal malignant masses. / Cirugía laparoscópica en grandes masas suprarrenales malignas.

ABSTRACT

OBJECTIVE: The aim of this article is to describe the surgical technique of laparoscopic resection in malignant tumors greater than 10 cm. METHODS: We present two cases, a 63 year old woman with a left adrenal heterogeneous mass of 11 cm in maximum diameter and an 80 year old man with a left adrenal heterogeneous mass 13 cm in maximum diameter. In both cases excision was performed laparoscopically using 4 trocars and the Alexis® wound retractor for specimen extraction. RESULTS: For the 63 year old woman, the histological result was malignant epithelioid angiomyolipoma, while in the case of the 80 year old man was large cell neuroendocrine carcinoma with possible pulmonary origin. CONCLUSIONS: We believe that laparoscopic surgery of large masses of malignant behavior depends on the capsular integrity and their relationship to adjacent structures rather than tumor size or the internal characteristics of tumor on imaging tests.