Adenomatoid Tumor of the Adrenal Gland in Young Woman: From Clinical and Radiological to Pathological Study

Abstract

Adenomatoid tumors are neoplasms of mesothelial origin, usually occurring in the male and female genital tracts. Extragenital localization sites such as adrenal glands are rare but have been reported. When found in the adrenals, they represent great clinical, radiological and pathological diagnostic challenge, with wide range of differential diagnoses to be considered. We present a case of a 30 years old female, with incidental ultrasound finding of unilateral tumor in the right adrenal gland. Multi slices CT scan was of value in localizing this tumor, but not in the precise diagnosis. The tumor ranged from 5.6 cm to 6.4 cm in greatest diameter. Clinical and hormonal examinations excluded Sy. Cushing, M. Conn and pheochromocytoma. The patient underwent laparoscopic right adrenalectomy. A large tumor (d: 8 × 7 × 3 cm) was removed showing no infiltration of the adrenal cortex or medulla, or extra-adrenal extension into the periadrenal adipose tissue. Histological examination showed numerous cystic spaces lined by flattened cubical epithelial cells. The small cystic spaces were separated by edematous fibrovascular stroma with rare epithelial cells with vacuolated cytoplasm. Immunohistochemical staining was positive with vimentin (+), S100 (+), MCA mesothelial Ag (+), CD 68 (+) and negative with acitin (-), CK7 (-), CD3 (-). Adenomatoid tumor is a rare benign neoplasm that should be added in the differential diagnosis of any adrenal tumor occurring in adrenal gland. The histological and immunohistochemical profiles of this adrenal adenomatoid tumor are very supportive in reaching the diagnosis of this benign tumor of a mesothelial cell origin, helping to avoid invasive treatment.

Primary adenomatoid tumor of the adrenal gland: A case report and literature review

“…Except for 4 patients who were not available, lymphocytic infiltration or aggregation was observed in 27 patients and not reported in 10 patients. [2–31]…”

Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque

“…Depending on the anatomic site its name differs: pleura (lining the lungs and chest wall), peritoneum (lining the abdominal organs and wall), pericardium (lining the heart) and tunica vaginalis (lining the testes). Adenomatoid tumors usually occur in the genital tract of both sexes and less frequently in heart, 2 mediastinum, 3‐5 pancreas, 6 liver, 7‐12 pleura, 13 mesocolon, 14 omentum, 14‐16 lymph node, 17 peritoneum, 9,18 intestinal mesentery, 19 adrenal glands, 20‐55 and skin 56 . Most tumors are discovered incidentally.…”

A rare case of adenomatoid tumour presented as back pain: case report and brief review of the literature

“…Adenomatoid tumors are not associated with diabetes, but seven cases were found to be associated with hypertension. 3…”