Adenomatoid tumor of the adrenal gland mimicking an echinococcus cyst of the liver – A case report

Hoffmann, Martin; Yedibela, S.; Dimmler, Arno; Hohenberger, Werner; Meyer, Thomas

doi:10.1016/j.ijsu.2006.06.025

Cited by 12 publications

(9 citation statements)

References 9 publications

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“…As expected, intracellular or extracellular epithelial mucin was not seen using Diastase-periodic acid-Schiff or mucicarmin histochemical stains, but stromal mucin (alcian blue positive) has been demonstrated. Lymphoid infiltrates 20,29 and metaplastic ossification 20 have been described as well. Immunohistochemistry has been performed in 29 cases, always showing the usual immunohistochemical profile of mesothelial cells, including strong immunoreactivity for cytokeratin (pankeratin, high-molecular weight cytokeratin 5/6) and calretinin.…”

Section: Authors' Commentmentioning

confidence: 99%

“…Tumor size varied from less than 1 cm to 15 cm (Table 1). Grossly the majority of AT-AG were similar to their genital counterparts and presented as solid tumors, firm or soft in consistency, whereas some have been described as solid with cystic areas, and only 5 were described as entirely or almost entirely cystic 9,15,21,29 (Table 1). On histology AT-AG are described both as circumscribed with welldefined capsule walls and as infiltrative, 7,10,11,15,16,18,21,28 occasionally penetrating into the periadrenal adipose tissue.…”

Section: Authors' Commentmentioning

confidence: 99%

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Cystic Lymphangioma-like Adenomatoid Tumor of the Adrenal Gland: Case Presentation and Review of the Literature

Bisceglia¹,

Carosi²,

Scillitani

et al. 2009

Advances in Anatomic Pathology

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Adenomatoid tumors (AT) are usually found in the genital tract of both sexes. They are very rarely located in extragenital sites, and are exceedingly rare in the adrenal. AT of the adrenal gland (AT-AG) are nonfunctioning, usually discovered incidentally and confused on imaging with other more common adrenal neoplasms. The overwhelming majority occur in males. Thirty-four cases have been reported so far, more often presenting grossly as solid tumors, rarely as solid with cystic areas, and 5 cases were almost entirely cystic. At histology they can be either circumscribed or locally infiltrative, and may pose diagnostic difficulties when the pathologist relies on morphology alone or is challenged on frozen section. On light microscopy the diagnosis may be very difficult if the tumor is rich in vacuolated cells, mimicking metastatic signet ring-cell adenocarcinoma. Immunophenotyping and/or electron microscopy are paramount in helping to ascertain their mesothelial lineage. Lymphangioma is the main histologic mimic of solid-cystic and cystic AT-AG, but lymphangioma is immunopositive for endothelial markers and negative for cytokeratins and mesothelial markers. Ultrastructural analysis has been performed in 10 published cases of AT-AG, in all of which the classical microvilli of coelomic type were always observed. In brief we report herein the sixth case of cystic lymphangioma-like AT, which was incidentally discovered during clinical follow-up in a 39-year-old man undergoing cancer staging and surveillance after surgery. The adrenal tumor was 5.5 cm in size and was fully investigated immunohistochemically and ultrastructurally. A complete review of the literature is also presented.

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Section: Authors' Commentmentioning

confidence: 99%

Section: Authors' Commentmentioning

confidence: 99%

Cystic Lymphangioma-like Adenomatoid Tumor of the Adrenal Gland: Case Presentation and Review of the Literature

Bisceglia¹,

Carosi²,

Scillitani

et al. 2009

Advances in Anatomic Pathology

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“…Other histological characteristics have been noted including dystrophic calcifications (6,10,(15)(16)(17)19), intratumoral adipose tissue (14,18,22) and metaplastic ossification (15). Timonera et al (18) reported two cases of composite AT and myelolipoma with unclear pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…Lymphocyte infiltration and aggregates can be found in most cases which is also the histological feature of adrenal ATs. Other histological characteristics have been noted including dystrophic calcifications ( 6 , 10 , 15 – 17 , 19 ), intratumoral adipose tissue ( 14 , 18 , 22 ) and metaplastic ossification ( 15 ). Timonera et al.…”

Section: Discussionmentioning

confidence: 99%

Adenomatoid Tumor of the Adrenal Gland: Report of Two Cases and Review of the Literature

Guan

Zhao

et al. 2021

Front. Endocrinol.

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Adenomatoid tumor (AT) is an uncommon benign neoplasm of mesothelial origin, usually occurring in the female and male genital tracts. Extragenital localization such as the adrenal gland is extremely rare. Until now, only 39 cases of adrenal AT have been reported in the English literature. Here we report two novel cases of adrenal AT that occurred in male patients aged 30 and 31 years. The tumors were discovered incidentally by computed tomography (CT). Macroscopically, the tumors were unilateral and solid, and the greatest dimension of the tumors was 3.5 and 8.0 cm, respectively. Histologically, the tumors consisted of angiomatoid, cystic, and solid patterns and infiltrated the adrenal cortical or medullary tissue. The tumor cells had low nuclear/cytoplasmic ratio, with no pathological mitosis or nuclear pleomorphism. Thread-like bridging strands and signet-ring-like cells could be seen. Immunohistochemically, the tumor cells were positive for epithelial markers (AE1/AE3, CK7) and mesothelial markers (D2-40, calretinin, and WT-1). The Ki-67 index was approximately 1 and 2%, respectively. The differential diagnosis of adrenal AT includes a variety of benign and malignant tumors. The patients had neither local recurrence nor distant metastasis at 21 and 8 months after removal of the tumor. In the literature review, we comprehensively summarized the clinical, morphological, immunohistochemical, and prognostic features of adrenal AT. Adrenal ATs are morphologically and immunophenotypically identical to those that occur in the genital tracts. Combining the histology with immunohistochemical profiles is very supportive in reaching the diagnosis of this benign tumor, helping to avoid misdiagnosis and overtreatment.

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“…Another two cases of verified AT were excluded due to extragenital site of origin (one from the subserosa of the stomach and one from the adrenal gland, both in male patients). The adrenal tumor has been reported in detail previously [19]. Thus, a total of 47 genital tract ATs were included in this study.…”

Section: Methodsmentioning

confidence: 99%

Adenomatoid tumors of the female and male genital tract. A comparative clinicopathologic and immunohistochemical analysis of 47 cases emphasizing their site-specific morphologic diversity

et al. 2011

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Adenomatoid tumors (ATs) are uncommon benign mesothelial tumors with a predilection for the genital tract. We reviewed 47 ATs diagnosed at our institutions during 10-year period. Thirty tumors (64%) originated in the female (21 uterine, 8 tubal, and 1 ovarian) and 17 (36%) in the male (9 epididymal and 8 testicular) genital tract. The median age for females and males was 47.5 and 51 years, respectively. While 83% of tumors in females were incidental findings in resections for unrelated diseases, 94% of male lesions presented as clinical masses leading to surgery. The median size was 2, 1, and 0.5 cm for uterine, epididymo-testicular, and tubo-ovarian lesions, respectively. Architecturally, the microcystic/angiomatoid pattern was the most frequent (32/47; 68%), followed by combined microcystic/trabecular (26/47; 55%) and retiform/adenoid (15/47; 32%) pattern. The trabecular/solid (6%) and macrocystic (4%) patterns were uncommon. However, 57% of cases revealed ≥2 growth patterns. Taken by anatomic site, 20 of 21 uterine cases were at least focally microcystic but none was retiform. In contrast, the retiform pattern dominated in male genital tract tumors (12/17; 71%). Immunohistochemistry showed expression of calretinin (36/36) and D2-40 (30/30) and lack of CD34 (0/30) and PAX8 (0/32). GLUT-1 was expressed in 11/11 male genital tract tumors but in none of the microcystic uterine lesions. Estrogen and progesterone receptor expression was weak and focal (two and three uterine cases, respectively). None stained for the androgen receptor. Our study illustrates the great site-specific morphological diversity of ATs emphasizing their wide site-dependent differential diagnosis.

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Adenomatoid tumor of the adrenal gland mimicking an echinococcus cyst of the liver – A case report

Cited by 12 publications

References 9 publications

Cystic Lymphangioma-like Adenomatoid Tumor of the Adrenal Gland: Case Presentation and Review of the Literature

Cystic Lymphangioma-like Adenomatoid Tumor of the Adrenal Gland: Case Presentation and Review of the Literature

Adenomatoid Tumor of the Adrenal Gland: Report of Two Cases and Review of the Literature

Adenomatoid tumors of the female and male genital tract. A comparative clinicopathologic and immunohistochemical analysis of 47 cases emphasizing their site-specific morphologic diversity

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