A vinyl chloride-exposed worker with an adrenal gland angiosarcoma: a case report

Abstract

Adrenal epithelioidangiosarcoma (AEA) is a rare neoplasm that accounts for less than 1% of sarcomas. Due to its rarity, it can easily be misdiagnosed, both by the clinician and the pathologist. Data on the patient's occupational history was collected and analyzed. The bibliographic data was found on the PUBMED bibliographic search site after entering the word "extrahepaticangiosarcoma". We report a case of adrenal epithelioidangiosarcoma (AEA) in a 68 yr-old Caucasian male factory worker exposed to Vinyl Chloride (VC) for 15 yr. He underwent surgery, chemotherapy and radiotherapy. Hepatic angiosarcoma is a known consequence of VC exposure, but occupational causality of extra-hepatic angiosarcoma is controversial. Extra-hepatic angiosarcomas have been reported in VC workers, but never AEA. Cancerogenic effects of VC involve all endothelial areas of the body and extra-hepatic endothelial tumors may also be caused by this substance. This is the first published report of AEA diagnosed in a worker exposed to VC.

Fig. 1.

Left suprarenal mass and metastasis near the posterior abdominal wall.

Fig. 2.

Clear cells as hyperplastic adrenal tissue (bottom) and neoplastic vascular channels (top) with malignant endothelial epithelioid cells (hematoxylin-eosin ×32).

Fig. 3.

Immunohistochemical staining for CD31 antigen. Note intense brown coloration of the membrane of the endothelial neoplastic cells with residual negative adrenal tissue (×40).