Limits...
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, postoperative specimen
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4374271&req=5

Figure 11: Left suprarenal mass, postoperative specimen

Mentions: A 50-year-old female came with dull aching left loin pain for 2 months. Clinical examination was noncontributory. An abdominal ultrasound showed a left supra renal mass lesion, which was uniformly hypoechoic. Metabolic evaluation including serum electrolytes, plasma metanephrines and serum cortisol were within normal limits. MRI showed uniformly hypointense mass in T1-wieghted images and a very hyperintense mass lesion on T2-weighted images (light bulb sign), which made us to suspect a pheochromocytoma [Figures 9 and 10]. So we prepared the patient for surgery anticipating a pheochromocytoma. The tumor was removed by open approach [Figure 11], and the postoperative period was uneventful. But to our surprise, the lesion turned out to be juxta-adrenal schwannoma arising from nerve sheaths on histopathological examination [Figure 12]. IHC confirmed the diagnosis and was positive for S-100.


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, postoperative specimen
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 11: Left suprarenal mass, postoperative specimen
Mentions: A 50-year-old female came with dull aching left loin pain for 2 months. Clinical examination was noncontributory. An abdominal ultrasound showed a left supra renal mass lesion, which was uniformly hypoechoic. Metabolic evaluation including serum electrolytes, plasma metanephrines and serum cortisol were within normal limits. MRI showed uniformly hypointense mass in T1-wieghted images and a very hyperintense mass lesion on T2-weighted images (light bulb sign), which made us to suspect a pheochromocytoma [Figures 9 and 10]. So we prepared the patient for surgery anticipating a pheochromocytoma. The tumor was removed by open approach [Figure 11], and the postoperative period was uneventful. But to our surprise, the lesion turned out to be juxta-adrenal schwannoma arising from nerve sheaths on histopathological examination [Figure 12]. IHC confirmed the diagnosis and was positive for S-100.

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