Epithelioid Angiosarcoma of the Adrenal Gland. Report of a Case and Review of the Literature

Stavridis, Sotir; Mickovski, A.; Filipovski, Vanja; Banev, Sasho; Dohcev, Sasho; Lekovski, Ljupcho

doi:10.3889/mjms.1857-5773.2010.0119

Cited by 7 publications

(15 citation statements)

References 30 publications

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“…However, immunohistochemical staining results using endothelial markers (CD31, CD34, ERG, FLI-1 and factor VIII) can confirm the endothelial differentiation of the neoplasm. [3][4][5][6]11,12 The diagnosis of angiosarcoma can be a challenge due to pathohistologic features mimicking IPEH (Masson's tumour) as seen in the current case. IPEH is a benign, reactive process that cannot be differentiated radiologically from other benign or malignant lesions.…”

Section: Discussionmentioning

confidence: 99%

“…1,5,7,10,11 Low incidence rates and non-specific radiologic or histologic features contribute to the difficulty of an angiosarcoma diagnosis. Histologically, it is characterized by solid sheets or nests of epithelioid cells with cellular pleomorphism, increased mitotic activity, eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli.…”

Section: Discussionmentioning

confidence: 99%

“…Histologically, it is characterized by solid sheets or nests of epithelioid cells with cellular pleomorphism, increased mitotic activity, eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli. [1][2][3][4][5]7,11,12 Furthermore, angiosarcoma tends to have a positive immunoreactivity angiosarcoma of the adrenal gland for cytokeratin, a marker of epithelial tumours. [2][3][4][5]7,11,12 Taken together, these factors can contribute to a misdiagnosis of metastatic carcinoma or adrenal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] It occurs predominantly in the soft tissue and skin, although other sites including the breast, bone, liver and spleen have been reported. 3,5,6 Angiosarcoma of the adrenal gland is exceedingly rare and only several cases have been reported. 2,7 The prognosis of patients with angiosarcoma is poor, with 5-year survival rates ranging from 24% to 31%.…”

Section: Introductionmentioning

confidence: 99%

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Angiosarcoma of the adrenal gland with concurrent contralateral advanced renal cell carcinoma: A diagnostic and management dilemma

Gusenbauer

Ruzhynsky

Kak

et al. 2015

CUAJ

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Angiosarcoma is a rare high-grade malignant neoplasm with poor clinical outcome and survival rates, occurring most commonly in the skin and soft tissue. It is composed of neoplastic cells that demonstrate endothelial differentiation. The diagnosis of angiosarcoma can be difficult due to its pathohistologic presentation as a poorly differentiated neoplasm with associated secondary changes. We report a case of angiosarcoma of the adrenal gland with concurrent contralateral renal cell carcinoma (RCC) and renal vein thrombus. The presumptive clinical diagnosis was metastatic renal cell carcinoma to the contralateral adrenal gland. Pathohistologic evaluation demonstrated massive hematoma associated with intravascular papillary endothelial hyperplasia (IPEH)-like features. We discuss the pathohistological features used to ascertain a diagnosis of angiosarcoma in the presence of IPEH-like changes and differentiate it from reactive vascular proliferation seen in IPEH (Masson's tumour).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Angiosarcoma of the adrenal gland with concurrent contralateral advanced renal cell carcinoma: A diagnostic and management dilemma

Gusenbauer

Ruzhynsky

Kak

et al. 2015

CUAJ

View full text Add to dashboard Cite

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“…The different surgical procedures are generally determined on the basis of the size and extension of the tumor. Also, postoperative chemotherapy and radiotherapy are chosen on the basis of the exhibited size and metastatic status of the tumor (11). In most cases, the neoplasms were reported to be well circumscribed and invasive, with a solid or cystic appearance (10).…”

Section: Discussionmentioning

confidence: 99%

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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A case report of primary adrenal angiosarcoma as depicted on magnetic resonance imaging

Yang

Reng

et al. 2017

Medicine

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Rationale:Angiosarcoma is an extremely rare malignant tumor of endothelial origin. The majority of studies reporting angiosarcoma have been concerned with the clinical and pathological aspects, with limited reporting of their imaging findings. To our knowledge, angiosarcoma of the adrenal gland is very rare. Herein we firstly report a primary adrenal angiosarcoma depicted on magnetic resonance imaging (MRI).Patient concerns:A 59-year-old man was referred to our hospital for 1 year left-flank pain that exacerbated in recent 4 months.Diagnosis:A regular mass with clear boundary was revealed on MRI in the region of left adrenal gland. Its signal intensity was inhomogeneous. It mainly showed isointensity with patchy slight hyperintensity on T1-weighted images and marked hyperintensity with patchy hypointensity on T2-weighted images. On contrast-enhanced images, it demonstrated significantly heterogeneous enhancement, and the peripheral solid component showed delayed enhancement. Bulky blood vessels and hemorrhage were identified in the tumor.Interventions:The mass was surgically excised under a left laparoscopic adrenalectomy.Outcomes:Left adrenal angiosarcoma was confirmed by pathological and immunohistochemical examinations. No evidence of recurrence was found 6 months after operation.Lessons:In conclusion, primary adrenal angiosarcoma has some MRI features corresponding to its pathological nature. It should be included in the differential diagnosis when a mass was detected in the adrenal gland.

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Epithelioid Angiosarcoma of the Adrenal Gland. Report of a Case and Review of the Literature

Cited by 7 publications

References 30 publications

Angiosarcoma of the adrenal gland with concurrent contralateral advanced renal cell carcinoma: A diagnostic and management dilemma

Angiosarcoma of the adrenal gland with concurrent contralateral advanced renal cell carcinoma: A diagnostic and management dilemma

Adrenal angiosarcoma

A case report of primary adrenal angiosarcoma as depicted on magnetic resonance imaging

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