Advancing experience with laparoscopic solid organ surgery has allowed surgeons to fully mobilize and resect solid organs previously thought amenable only to open approaches. We present the preoperative workup of a patient with a 19cm right adrenal mass and our technique for laparoscopic resection of this giant adrenal tumor.

A 50 year old woman presented with vague abdominal pain. Workup showed a 19 cm right adrenal mass. CT, MRI, PET, and biopsy were utilized following metabolic workup to evaluate for extracapsular extension, vascular invasion, and metastatic disease.

Laparoscopic resection was offered to the patient and was successful. With proper workup through imaging to determine resectability, laparoscopic mobilization and resection of even giant adrenal masses is feasible and safe in experienced hands.