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Adrenal schwannoma treated with laparoscopic surgery.

Onoda N, Ishikawa T, Toyokawa T, Takashima T, Wakasa K, Hirakawa K - JSLS (2008 Oct-Dec)

Bottom Line: It was successfully treated with laparoscopic adrenalectomy.The cortex was compressed but showed no atrophy.We reviewed the cases reported previously in an attempt to reveal the characteristic features of this rare disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan. nonoda@med.osaka-cu.ac.jp

ABSTRACT

Objective: We report a case of left adrenal schwannoma in a 62-year-old man, incidentally discovered on an abdominal computed tomography. It was successfully treated with laparoscopic adrenalectomy.

Methods: On admission, no remarkable findings were recognized in the patient's blood and urine examination, including adrenal function. Laparoscopic left adrenalectomy was performed with the diagnosis of a nonfunctioning adrenal tumor.

Results: Macroscopically, the tumor (45 mm x 30 mm, 60 g) arose from the medulla of the adrenal gland with a clear border distinguishing it from surrounding tissues. Histologically, the tumor consisted uniformly of spindle cells that were positive for S-100. The cortex was compressed but showed no atrophy. The diagnosis of adrenal schwannoma was made.

Conclusion: Although an increasing number of adrenal incidentaloma have been identified with the recent advances in imaging techniques, only a few cases of schwannoma of the adrenal gland have been reported. We reviewed the cases reported previously in an attempt to reveal the characteristic features of this rare disease.

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Related in: MedlinePlus

Magnetic resonance imaging revealed a round mass in the left adrenal gland. The mass registered low-signal intensity on the T1-weighted image (A), and a slightly heterogeneously high-signal intensity on the T2-weighted image (B).
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Figure 1: Magnetic resonance imaging revealed a round mass in the left adrenal gland. The mass registered low-signal intensity on the T1-weighted image (A), and a slightly heterogeneously high-signal intensity on the T2-weighted image (B).

Mentions: A 62-year-old man was referred to our hospital for further examination and treatment of his incidentaloma of the left adrenal gland. A local physician diagnosed the patient with mild liver dysfunction, and the patient had undergone an abdominal computed tomography as part of his workup. A round mass with a maximum diameter of 40 mm was recognized on the left adrenal gland. On admission, the patient was 161 cm tall and weighed 67 kg. His blood pressure was 132/92 mm Hg. No physical features were present to suggest Cushing's syndrome or von Recklinghausen's disease. The abdomen was soft and flat, and no abnormal mass was palpable. Magnetic resonance imaging (MRI) revealed a round mass 40 mm in diameter in the patient's left adrenal gland. The mass had a clear border setting it off from surrounding structures, and a portion of the mass had a lobular surface. The mass had low-signal intensity on a T1-weighted image and demonstrated slightly heterogeneous high-signal intensity on a T2-weighted image (Figure 1). Blood count and biochemistry were normal. Endocrinological examinations revealed no remarkable findings to suggest a functioning adrenal tumor (Table 1). Although ACTH was slightly elevated, it was thought to be nonspecific, because no alterations in either the morning level or the daily rhythm of cortisol secretion was observed. The diagnosis was made of a nonfunctioning left adrenal tumor. Because of the size and partly irregular shape of the mass, a laparoscopic transabdominal left adrenalectomy was performed to rule out a malignant tumor.


Adrenal schwannoma treated with laparoscopic surgery.

Onoda N, Ishikawa T, Toyokawa T, Takashima T, Wakasa K, Hirakawa K - JSLS (2008 Oct-Dec)

Magnetic resonance imaging revealed a round mass in the left adrenal gland. The mass registered low-signal intensity on the T1-weighted image (A), and a slightly heterogeneously high-signal intensity on the T2-weighted image (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3015997&req=5

Figure 1: Magnetic resonance imaging revealed a round mass in the left adrenal gland. The mass registered low-signal intensity on the T1-weighted image (A), and a slightly heterogeneously high-signal intensity on the T2-weighted image (B).
Mentions: A 62-year-old man was referred to our hospital for further examination and treatment of his incidentaloma of the left adrenal gland. A local physician diagnosed the patient with mild liver dysfunction, and the patient had undergone an abdominal computed tomography as part of his workup. A round mass with a maximum diameter of 40 mm was recognized on the left adrenal gland. On admission, the patient was 161 cm tall and weighed 67 kg. His blood pressure was 132/92 mm Hg. No physical features were present to suggest Cushing's syndrome or von Recklinghausen's disease. The abdomen was soft and flat, and no abnormal mass was palpable. Magnetic resonance imaging (MRI) revealed a round mass 40 mm in diameter in the patient's left adrenal gland. The mass had a clear border setting it off from surrounding structures, and a portion of the mass had a lobular surface. The mass had low-signal intensity on a T1-weighted image and demonstrated slightly heterogeneous high-signal intensity on a T2-weighted image (Figure 1). Blood count and biochemistry were normal. Endocrinological examinations revealed no remarkable findings to suggest a functioning adrenal tumor (Table 1). Although ACTH was slightly elevated, it was thought to be nonspecific, because no alterations in either the morning level or the daily rhythm of cortisol secretion was observed. The diagnosis was made of a nonfunctioning left adrenal tumor. Because of the size and partly irregular shape of the mass, a laparoscopic transabdominal left adrenalectomy was performed to rule out a malignant tumor.

Bottom Line: It was successfully treated with laparoscopic adrenalectomy.The cortex was compressed but showed no atrophy.We reviewed the cases reported previously in an attempt to reveal the characteristic features of this rare disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan. nonoda@med.osaka-cu.ac.jp

ABSTRACT

Objective: We report a case of left adrenal schwannoma in a 62-year-old man, incidentally discovered on an abdominal computed tomography. It was successfully treated with laparoscopic adrenalectomy.

Methods: On admission, no remarkable findings were recognized in the patient's blood and urine examination, including adrenal function. Laparoscopic left adrenalectomy was performed with the diagnosis of a nonfunctioning adrenal tumor.

Results: Macroscopically, the tumor (45 mm x 30 mm, 60 g) arose from the medulla of the adrenal gland with a clear border distinguishing it from surrounding tissues. Histologically, the tumor consisted uniformly of spindle cells that were positive for S-100. The cortex was compressed but showed no atrophy. The diagnosis of adrenal schwannoma was made.

Conclusion: Although an increasing number of adrenal incidentaloma have been identified with the recent advances in imaging techniques, only a few cases of schwannoma of the adrenal gland have been reported. We reviewed the cases reported previously in an attempt to reveal the characteristic features of this rare disease.

Show MeSH
Related in: MedlinePlus