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A case series of two cases of juxta-adrenal schwannoma presenting as adrenal mass lesion and review of the literature.

Damodaran S, Mahimairaj G, Velaichamy K - Urol Ann (2015 Apr-Jun)

Bottom Line: Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining.Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors.We report a unique imaging characteristic, which helps in preoperative identification these rare lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.

ABSTRACT
Schwannomas are rare tumors in the retroperitoneal location. They can pose a diagnostic dilemma when presenting as an adrenal mass lesion due to their imaging characteristics. We report two cases of juxta-adrenal schwannomas presenting as symptomatic adrenal mass lesions. In both the cases, the clinical examination and functional evaluation was unremarkable and the radiological examination revealed a mixed intense adrenal mass lesion in one case with predominantly hyperintense areas and a very hyperintense lesion in another, in T2-weighted images, mimicking a adrenocortical malignancy and a pheochromocytoma respectively. Both cases were treated by surgical excision. Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining. Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors. We report a unique imaging characteristic, which helps in preoperative identification these rare lesions.

No MeSH data available.


Related in: MedlinePlus

Left suprarenal mass exposed
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Figure 3: Left suprarenal mass exposed

Mentions: A 26-year-old female came with dull aching right loin pain. Clinical examination was noncontributory. An abdominal ultrasound showed eight by nine cm mixed echogenic mass in left suprarenal region. Metabolic evaluation including plasma metanephrines, cortisol, serum electrolytes was within normal limits. Magnetic resonance imaging (MRI) showed mixed intense solid mass with predominantly hyperintense areas, of size eight by nine cm in the left adrenal gland [Figures 1 and 2]. Based on the clinical and radiological features we had a strong suspicion of an adrenocortical carcinoma and did an open adrenalectomy [Figures 3–6]. Postoperative period was uneventful. Histopathological examination Showed features of schwannoma [Figure 7] in a juxta-adrenal location. Immunohistochemistry (IHC) confirmed the diagnosis and was positive for S-100 [Figure 8] and negative for vimentin.


A case series of two cases of juxta-adrenal schwannoma presenting as adrenal mass lesion and review of the literature.

Damodaran S, Mahimairaj G, Velaichamy K - Urol Ann (2015 Apr-Jun)

Left suprarenal mass exposed
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374271&req=5

Figure 3: Left suprarenal mass exposed
Mentions: A 26-year-old female came with dull aching right loin pain. Clinical examination was noncontributory. An abdominal ultrasound showed eight by nine cm mixed echogenic mass in left suprarenal region. Metabolic evaluation including plasma metanephrines, cortisol, serum electrolytes was within normal limits. Magnetic resonance imaging (MRI) showed mixed intense solid mass with predominantly hyperintense areas, of size eight by nine cm in the left adrenal gland [Figures 1 and 2]. Based on the clinical and radiological features we had a strong suspicion of an adrenocortical carcinoma and did an open adrenalectomy [Figures 3–6]. Postoperative period was uneventful. Histopathological examination Showed features of schwannoma [Figure 7] in a juxta-adrenal location. Immunohistochemistry (IHC) confirmed the diagnosis and was positive for S-100 [Figure 8] and negative for vimentin.

Bottom Line: Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining.Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors.We report a unique imaging characteristic, which helps in preoperative identification these rare lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India.

ABSTRACT
Schwannomas are rare tumors in the retroperitoneal location. They can pose a diagnostic dilemma when presenting as an adrenal mass lesion due to their imaging characteristics. We report two cases of juxta-adrenal schwannomas presenting as symptomatic adrenal mass lesions. In both the cases, the clinical examination and functional evaluation was unremarkable and the radiological examination revealed a mixed intense adrenal mass lesion in one case with predominantly hyperintense areas and a very hyperintense lesion in another, in T2-weighted images, mimicking a adrenocortical malignancy and a pheochromocytoma respectively. Both cases were treated by surgical excision. Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining. Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors. We report a unique imaging characteristic, which helps in preoperative identification these rare lesions.

No MeSH data available.


Related in: MedlinePlus