title: Intraoperative identification of adrenal-renal fusion.
abstract: Adrenal - renal fusion is a rare entity defined as incomplete encapsulation of the adrenal gland and kidney with histologically adjacent functional tissue. This report describes the first published intraoperative identification of this anomaly during laparoscopic adrenalectomy. The patient was a 59-year-old man with chronic hypertension refractory to multiple antihypertensives found to be caused by a right-sided aldosterone-producing adrenal adenoma in the setting of bilateral adrenal hyperplasia. During laparoscopic adrenalectomy, the normal avascular plane between the kidney and adrenal gland was absent. Pathologic evaluation confirmed adrenal - renal fusion without adrenal heterotopia. Identified intraoperatively, this may be misdiagnosed as invasive malignancy, and thus awareness of this anomaly may help prevent unnecessarily morbid resection.
authors.affiliation: Department of Surgery, Tufts Medical Center, Boston, MA, USA.
authors.forename: Griffin
authors.initials: G
authors.lastname: Boll
authors.affiliation: Department of Surgery, Tufts Medical Center, Boston, MA, USA.
authors.forename: Rishi
authors.initials: R
authors.lastname: Rattan
authors.affiliation: Department of Pathology, Tufts Medical Center, Boston, MA, USA.
authors.forename: Osman
authors.initials: O
authors.lastname: Yilmaz
authors.affiliation: Department of Surgery, Tufts Medical Center, Boston, MA, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Tarnoff
keywords: Adrenal; fusion; kidney