title: Laparoscopic surgery in great adrenal malignant masses.
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.
authors.affiliation: Instituto IBS Granada. Granada. España.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arrabal-Polo
authors.affiliation: UGC Cirugía General y del Aparato Digestivo Hospital La Inmaculada-Torrecárdenas.Huercal-Overa. Almería. España.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fabiano
authors.affiliation: UGC Cirugía General y del Aparato Digestivo Hospital La Inmaculada-Torrecárdenas.Huercal-Overa. Almería. España.
authors.forename: Almudena
authors.initials: A
authors.lastname: Moreno
authors.affiliation: UGC Urología. Hospital La Inmaculada-Torrecárdenas. Huercal-Overa. Almería. España.
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Cano-García
authors.affiliation: UGC Cirugía General y del Aparato Digestivo Hospital La Inmaculada-Torrecárdenas.Huercal-Overa. Almería. España.
authors.forename: Jaime
authors.initials: J
authors.lastname: Jorge
authors.affiliation: UGC Cirugía General y del Aparato Digestivo Hospital La Inmaculada-Torrecárdenas.Huercal-Overa. Almería. España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosado
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged