Adrenal adenomas, adrenocortical carcinomas, pheochromocytomas, myelolipomas and metastasis are some of the most frequent adrenal gland tumors. However, there are several other less common benign and malignant tumors that can affect adrenal glands. Our aim was to identify unusual tumors of adrenal glands presented in patients who had an adrenalectomy, their clinical presentation, surgical approach and postoperative complications.

We analyzed all patients who had an adrenalectomy in the Clinic for Endocrine Surgery, University Clinical Centre of Serbia, in the period 2012-2023.

Among 789 patients which had an adrenalectomy, there were 50 uncommon adrenal gland tumors including ganglioneuroma (n=11), oncocytoma (n=10), lymphangioma (n=4), adrenal lymphoma (n=3), fibrolipoma (n=3), leiomyosarcoma (n=3), composite adrenal tumors (n=3), vascular malformations (n=2), angiomyolipoma (n=2), schwannoma (n=2), mixed corticomedullary tumor (n=2), paraganglioma (n=1), non-diferentiated sarcomatoid neoplasia (n=1), angiosarcoma (n=1), leiomyoblastoma (n=1), and echinococcus cyst (n=1). One fifth of the cases presented as hormonally active tumors. Out of 50 cases, most common surgical approach was laparoscopic (70%), then open (22%) and retroperitoneoscopic (8%). Conversion from laparoscopic to open approach was documented in 10 cases. Tumor size varied from 3 to 10 cm and most common complication was haemostasis revision (n=3). Most of the tumors were benign, with 8 malignant cases.

Some adrenal gland tumors are relatively common pathohistological finding. However, rare benign and malignant neoplasms should be considered as differential diagnosis even in hormonally active adrenal gland tumors and require multidisciplinary approach.