A Vinyl Chloride-exposed Worker with an Adrenal Gland Angiosarcoma: A Case Report

Criscuolo, Mario; Valerio, Jacqueline; Gianicolo, M. E.; Gianicolo, Emilio Antonio Luca; Portaluri, Maurizio

doi:10.2486/indhealth.2013-0044

Cited by 19 publications

(19 citation statements)

References 45 publications

(54 reference statements)

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“…The metastatic foci were ruled out before the operation decision. Although the treatment modality for patients with adrenal angiosarcomas remains controversial, surgical eradication appears to have better outcomes (1). We also prefer open surgery with a right subcostal incision when malignancy is suspected.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, the treatment modality of this rare case is described as controversial (1,10). Due to limited experience with adrenal angiosarcomas, surgeons pursue different surgical extension procedures.…”

Section: Discussionmentioning

confidence: 99%

“…There is no evidence supporting the relationship between primary adrenal angiosarcoma and multiple neuroendocrine tumors. Also, administration of radiation therapy in the past or previous abdominal traumas has no correlation with adrenal angiosarcoma (1). In most cases, adrenal angiosarcomas are diagnosed coincidentally following routine workup for patient complaints, which are generally non-specific abdominal discomfort or pain (2,3).…”

Section: Introductionmentioning

confidence: 99%

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Adrenal angiosarcoma

et al. 2018

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Adrenal angiosarcoma is an uncommon neoplasm that derives from the vascular endothelium; due to its biological behavior, it should be distinguished from other adrenal tumors. We herein report a case of a 57-year-old woman with diagnosis of an adrenal tumor that was suspected to be malignant. The specimen was histopathologically proved to be an angiosarcoma. The patient was suffering from right upper quadrant pain; after laboratory and radiological workup, a non-functioning right adrenal mass, 14 cm in size, was recognized. A right subcostal incision was made, and adrenalectomy was performed successfully with tumor-free surgical margins. Two months after the operation, a positron emission tomography-computed tomography scan was ordered for follow-up. No tumor tissue or any other metastatic foci remained. The patient had been referred to our medical oncology department and underwent retroperitoneal radiotherapy. However, unfortunately, the patient died due to cardiac insufficiency during the follow-up period.Keywords: Adrenal angiosarcoma, adrenal gland, malignant vascular tumors, adrenal incidentaloma INTRODUCTIONAdrenal angiosarcomas are infrequently encountered neoplasms in daily practice; therefore, they are not well documented in the literature. The etiological factors of this neoplasm are still not clearly understood; however, in a case report, exposure to some carcinogens was believed to be the cause of an adrenal angiosarcoma. There is no evidence supporting the relationship between primary adrenal angiosarcoma and multiple neuroendocrine tumors. Also, administration of radiation therapy in the past or previous abdominal traumas has no correlation with adrenal angiosarcoma (1). In most cases, adrenal angiosarcomas are diagnosed coincidentally following routine workup for patient complaints, which are generally non-specific abdominal discomfort or pain (2, 3). In this report, we present a new case of adrenal gland angiosarcoma of unusual size, which will enrich the collected scientific data on this very rare clinical entity. CASE PRESENTATIONA 57-year-old female patient with right upper abdominal pain was admitted to our hospital. Her past medical history included hypertension and hypercholesterolemia, which were under control. On physical examination, slight tenderness was found in the right upper quadrant, without any rebound or Murphy's sign. Cholecystitis was one of our differential diagnoses; therefore, the patient underwent abdominal ultrasound (US). Multiple gallstones were detected; however, significantly, a 14-cm abdominal lesion was also recognized beneath the liver. Therefore, computed tomography (CT) scans of the abdomen (Figure 1) and chest were ordered. A heterogeneous mass 14×12 cm in diameter, originating from the right adrenal gland, was revealed without contrast dying. There were no additional metastatic disseminations. Blood and urinary analyses documented no hormonal activity of the tumor. Preoperative LDH measurement was 422 U/L, VMA was 1.93 mg/day, normetanephrine was 255.5 µg/24 h, m...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adrenal angiosarcoma

et al. 2018

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“…The etiology of EA remains unknown: apart from a case of exposure to arsenic [6] and a case of exposure to vynil chloride [29], the published case reports didn't succeed in identifying a clear correlation with the patients' exposure to carcinogens or with a significant incidence of other diseases, even though three patients had concomitant adrenal cortical adenoma [26,31,32] (Table I). The disease occurs more frequently in males (M/F= 28/9), ranges from 34 to 85 years of age, with a mean peak at 57 years.…”

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confidence: 99%

“…Too often, patients undergo surgery before a proper diagnosis is made and the high incidence of local relapses may sometimes be explained by inadequate approaches. Laparoscopy may be used carefully in district surgeries: among the studied case reports, it was used in four patients with a follow up no longer than one year [13,26,29,31].…”

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Fine-needle aspiration accuracy in the diagnosis of primary epithelioid angiosarcoma of the adrenal gland: a case report and review of the literature

Torelli

Radaelli

Colecchia

et al. 2017

CMI

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Primary epithelioid angiosarcoma of the adrenal gland is extremely rare. Only 37 cases have been reported in the scientific literature.Here we describe the case of a 55-year-old woman affected by metastatic angiosarcoma in the right adrenal gland, who died few days after the histological diagnosis made by fine-needle aspiration (FNA). This is the second case of primary epithelioid angiosarcoma diagnosed by FNA among scientific articles published in English in PubMed. Microscopically, the tumor showed a predominant epithelioid differentiation, thus making the diagnostic process more difficult than usual. Immunohistochemical examination revealed positive reactivity for cytokeratin, CD31, and CD34. The literature shows that epithelioid adrenal angiosarcoma has poor clinical outcome, especially when metastatic at presentation.

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