Oncocytary cells adrenal adenoma or adrenal oncocytoma is an extremely rare tumor, mainly composed by oncocytomes. The diagnosis is exclusively confirmed on histological findings. There are about 50 cases published in the scientific reviews, of which only one case described a pregnant woman.
We report an observation about a 31 years old patient, with no personal antecedent, explored in our unit for an adrenal masse, measuring 71×58×46 mm discovered during an abdominal CT scan done for low back pain.
Patient did not present obvious signs of adrenal hypersecrtion at clinical exam, we noticed some sympathic signs associated to an amenorrhea, and a pregnancy of 8 weeks of amenorrhea was then diagnosed. At CT scan the adrenal masse did not match with the characteristics of an adenomatous one, having a spontaneous density of 40 HU, and an absolute washout up to 33%.
Methoxylated drift and hormonal exploration were normal.
Regarding to the size of this mass and its radiological characteristics with a strong suspicion of malignancy, Surgical management was decides, and patient was treated at 12 weeks of amenorrhea with simple post-operative issues. Histological findings concluded to an adrenal adenoma with oncocytary cells presenting malignant potential (according to BISCEGLIA criteria).
Pregnancy was leaded to its term, with birth of a healthy new-born. The patient was followed for more than one year without recurrence.
Treatment of adrenal oncocytoma should always be surgical, with an exert as large as possible.
20 - 23 May 2017
European Society of Endocrinology