ECE2023 Eposter Presentations Adrenal and Cardiovascular Endocrinology (124 abstracts)
A rare case of a juxta-adrenal schwannoma presenting as an adrenal mass
Ariadna Prats Custal 1 , Theodora Michalopoulou Alevras 1,2,3 , Cristina Franco Borras 1 , Carlos Jareño Martinez 1 , Marc Vallve Bernal 3,4 , Laura Nevot Muro 4 , Anna Magarolas Aixalà 5 , Laia Martinez Guasch 1,2,3 , Silvia Näf Cortes 3,6 & Ana Megia 1,2,3
1Hospital Universitari Joan XXIII, Endocrinology and Nutrition, Tarragona, Spain; 2CIBER, CIBERDEM, Tarragona, Spain; 3Universitat Rovira i Virgili, Tarragona, Spain; 4Hospital Universitari Joan XXIII, Anatomical pathology, Tarragona, Spain; 5Hospital Universitari Joan XXIII, Radiology, Tarragona, Spain; 6Hospital Universitari Joan XXIII, General Surgery, Tarragona, Spain
Background: Retroperitoneal Schwannomas are rare and generally benign tumors originating from the neural sheath. In particular, juxta-adrenal schwannomas may be misdiagnosed as adrenal tumors due to their location and radiological characteristics.
Case Presentation: A 40-year-old female patient referred to our outpatient clinic owing to a left suprarenal mass of 35 mm incidentally discovered in an enhanced CT. She was asymptomatic and the clinical examination was unremarkable. The mass had an absolute wash-out of 80% in the enhanced CT and presented 36UH in the non-enhanced CT. In the MRI the lesion was hypointense on T1 sequences, with a slight loss of signal on out-of-phase sequences, with a heterogeneous signal on T2 sequences, diffusion restriction and progressive enhancement after intravenous contrast administration. Therefore, showing indeterminate characteristics. The FDG-PET-CT revealed a slightly hypermetabolic mass (SUVmax 5.14), without uptake in the MIGB-123I scintigraphy. The hormone evaluation ruled out a hypersecretory adrenal mass. The MRI performed after 8 months of follow-up showed a growth of 2 mm. She was diagnosed with an indeterminate adrenal mass and underwent laparoscopic adrenalectomy. After the surgery, she presented among the complications, a chylous fistula that resolved with drainage, parenteral nutrition, and a low-fat diet. The histopathological and immunohistochemistry findings reveal a juxta-adrenal cellular schwannoma. It was a rounded, well-defined, and non-encapsulated lesion of 3.5*2.7*2 cm diameter, located in the surrounding adipose tissue of the adrenal gland without contacting it. It had a cellular “Antoni A” pattern, no necrosis, occasional mitosis figures, and lymphoid aggregates at the periphery of the lesion. The cells were positive for Vimentin, S 100 and SOX10, and the Ki-67 index was 5%. In the follow-up CT at 6 months, there were no signs of recurrence.
Conclusion: Juxt-adrenal Schwannomas should be included in the differential diagnosis of adrenal incidentalomas. Being a mass next to the adrenal gland with indeterminate radiological features, often it is misdiagnosed as adrenal carcinoma or atypical adenoma. Complete surgical resection is the treatment of choice and histology and immunohistochemistry confirm the diagnosis.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more