Figure 1. The radiographical assessment of enhanced computed
tomography and I123-metaiodobenzylguanidine
scintigraphy findings.
Abdominal enhanced computed tomography showed that the right adrenal
tumor surrounded by a yellow circle had grown to 4 cm in diameter (A:
transverse plane, B: coronal plane).
I123-metaiodobenzylguanidine scintigraphy showed no
uptake (C: transverse plane).
Figure 2. Intraoperative findings, including the port layout for
laparoscopic surgery andhistopathological
findings.
The port layout at the operation showed a 12-mm port, mainly used as a
camera port, and a 5-mm port, mainly used as a working port (A). It was
important to keep the tumor as intact as possible, so we grasped the
tissue surrounding the tumor (B). Blood vessels were cut using the
vessel sealing system (C). Hematoxylin-eosin stain showed that the
surgical specimen consisted of round cells with rich neurofibrils and
<50% stroma of Schwann cells. The tumor cells had round
nuclei and eosinophilic vesicles and large cells that prominently showed
differentiation into ganglion cells (D). Immunohistochemical staining
showed positive findings for VIP (E).