Adrenal Schwannoma in an Elderly Man: A Case Report and Literature Review

Yorita, Kenji; Naroda, Takushi; Tamura, Masato; Ito, Satoshi; Nakatani, Kimiko

doi:10.2169/internalmedicine.7026-21

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Also, the size and high FDG uptake of the mass increased suspicion of malignancy in Case 3. Other than a previously reported case of a microcystic reticular adrenal schwannoma in which the SUVmax was 71.7, the SUVmax of reported adrenal schwannomas was between 2.8 and 10.3 (1,7,(12)(13)(14). Similar to these numbers, also in our cases, SUVmax values in Cases 1 and 3 were 9.94 and 7.1, respectively.…”

Section: Discussionsupporting

confidence: 80%

An unusual finding after adrenal surgery: a case series of adrenal schwannomas

et al. 2023

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Adrenal schwannomas are rare benign tumors with no specific imaging and laboratory findings to diagnose preoperatively. Due to the limited number of cases in the literature, clinical, imaging, and pathological findings are presented in this study. Case 1 is a 61-year-old woman patient who has a 31-mm mass in the right adrenal gland. This mass was nonfunctional; in imaging studies, this mass had a cystic necrotic component, and high 18-fluorodeoxyglucose (FDG) uptake was seen. There was no metaiodobenzylguanidine (MIBG) uptake. Laparoscopic transabdominal right adrenalectomy was performed, and the pathology result was consistent with adrenal schwannomas. Case 2 is a 63-year-old man patient who presented with a 38-mm mass in the left adrenal gland. This mass was nonfunctional and similar to that in Case 1; this mass had a cystic component. Laparoscopic transabdominal left adrenalectomy was performed. The diagnosis of adrenal schwannoma with degeneration was revealed. Case 3 was a 72-year-old woman patient admitted to the hospital for a 125-mm left adrenal mass. Similar to Case 1, this mass also had a cystic necrotic component in imaging studies. High FDG uptake was seen, and the patient underwent conventional adrenalectomy due to the suspicion of malignancy. After pathological evaluation, a diagnosis of adrenal schwannoma was made. A main diagnostic challenge in adrenal schwannomas is the preoperative diagnosis. These masses have no pathognomonic finding or specific hormonal function. Imaging findings of these masses may increase the suspicion of malignancy, which may affect decisions for surgery and the surgical technique.

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Section: Discussionsupporting

confidence: 80%

An unusual finding after adrenal surgery: a case series of adrenal schwannomas

et al. 2023

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“…[ 2 , 5 , 6 ] The head and extremities are the most frequent sites of schwannomas, [ 4 , 7 ] whereas the adrenal gland is a very uncommon location, with <100 documented cases to date. [ 2 , 8 , 9 ] Adrenal schwannomas arise from Schwann cells of the phrenic, vagus, or sympathetic nerves that innervate the adrenal medulla, and account for approximately 0.7% of adrenal tumors and 1% to 3% of all schwannomas. Cellular schwannomas in the adrenal gland are even more rare with <10 cases reported to date.…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of rare adrenal cellular schwannomas: A case report

Chen,

Huang,

Chen

et al. 2024

Medicine

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Background: Adrenal cellular schwannomas are exceptionally rare stromal tumors that are often misdiagnosed due to the lack of specific radiological, serological, or clinical features. In this report, we describe the differential diagnosis of a rare adrenal cellular schwannoma. Methods: A 69-year-old man with a history of persistent hypertension, chronic kidney disease, hypertensive heart disease, and cardiac insufficiency was hospitalized due to bilateral lower extremity edema lasting for 3 months. Plain computed tomography at that time revealed a space-occupying lesion in the right adrenal gland. As serum levels of catecholamines, cortisol, and adrenocorticotropic hormone were within normal ranges, the edema was attributed to the chronic kidney disease and cardiac insufficiency, and the patient was referred to our hospital for surgical treatment. Contrast-enhanced computed tomography revealed heterogeneous enhancement in the adrenal mass indicating pheochromocytoma. An irregularly shaped 5 cm mass with a complete capsule in the right adrenal gland was laparoscopically resected. The postoperative histopathological diagnosis was adrenal cellular schwannoma. Results: The postoperative course was unremarkable and the tumor did not recur during 5 years of follow-up. Conclusion: Adrenal cellular schwannoma is a very rare tumor that is extremely difficult to preoperatively diagnose. Histological and immunohistochemical analyses are required for differential diagnosis and confirmation. Cellular schwannomas can transform into malignant peripheral nerve sheath tumors, but not often. Consequently, regular postoperative follow-up is required for such patients, especially imaging.

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“…Genomic analyses have defined neurofibromatosis type 2 and schwannomatosis or Carney complex, 4,5 which have various morphologic appearances and very rarely undergo malignant transformation 5 . About 80 cases of AS have been reported in the literature 2 . AS patients are usually diagnosed with adrenal lesions while imaging for other diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Schwannoma, which is also known as neurilemmoma, is a common benign peripheral nerve sheath tumor that derives from the Schwann cells of the myelinated neural sheath 1 . The tumor can arise in any area of neural tissue; however, the common locations are the head, neck, mediastinum, and retroperitoneal space 2 . Adrenal schwannoma (AS) is rare and frequently misdiagnosed as adrenal cortical carcinoma 1 .…”

Section: Introductionmentioning

confidence: 99%

Adrenal Schwannoma Treated with Laparoscopic Adrenalectomy: A Case Report and Literature Review

Anukoolphaiboon,

Attawettayanon,

Innachit

2023

PSU Med J

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Adrenal schwannoma (AS) is extremely rare. We report on a 36-year-old female patient who presented with right upper abdominal pain. Preoperative computed tomography (CT) showed a 5-cm right adrenal mass. The metabolic work-up was normal. She underwent laparoscopic right adrenalectomy without complications. Microscopy and immunohistochemistry demonstrated a cellular schwannoma. One year after surgery, the patient was fine and without clinical recurrence or metastasis. Usually, the pre-operative diagnosis of AS is challenging and pathologic examination with immunohistochemistry is the only way to make a definite diagnosis.

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Adrenal Schwannoma in an Elderly Man: A Case Report and Literature Review

Cited by 7 publications

References 22 publications

An unusual finding after adrenal surgery: a case series of adrenal schwannomas

An unusual finding after adrenal surgery: a case series of adrenal schwannomas

Differential diagnosis of rare adrenal cellular schwannomas: A case report

Adrenal Schwannoma Treated with Laparoscopic Adrenalectomy: A Case Report and Literature Review

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