Ectopic adrenal cortical adenoma in the gastric wall: case report

Abstract

Ectopic adrenal cortical neoplasms are extremely rare. Ectopic adrenocortical tissue can be found in locations such as the celiac axis, the broad ligament, the adnexa of the testes, and the spermatic cord; however, they rarely involve the stomach. We report an unusual case of a patient with an ectopic adrenal cortical adenoma in the gastric wall. The patient was a 72-year old female admitted to our hospital with upper abdominal discomfort. Physical examination revealed tenderness below the xiphoid process. Both computed tomography and fibergastroscopy revealed a mass on the lesser curvature side of the gastric antrum; it was initially diagnosed as a gastric stromal tumor. After adequate preparation, the patient underwent surgery. During the procedure, we found a 30 mm × 30 mm mass with medium density in the lesser curvature near the gastric antrum within the serosa. Following immunohistochemistry examination, we corrected the diagnosis to an ectopic adrenal cortical adenoma; the tumor was nonfunctional.

Keywords: Adrenal adenoma; Adult; Ectopic adrenal cortical neoplasms; Nonfunctional adenoma; Stomach.

Figure 1

Enhanced image of nodule located in the lesser gastric curvature.

Figure 2

Elevated nodule on the lesser curvature side of the gastric antrum.

Figure 3

Analysis of tumor cells. A: Gastric wall mass, approximately 20 mm × 30 mm in size; B: Tumor cells under low power magnification; C: Tumor cells under high power magnification.

Figure 4

Immunohistochemistry. A: S-100 basement cell negative; B: Melan-A positive; C: CD34 positive.