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Case Reports
. 2016 Aug;10(8):PD01-2.
doi: 10.7860/JCDR/2016/20405.8265. Epub 2016 Aug 1.

Adrenal Schwannoma: A Rare Incidentaloma

Sumit Kumar  1 , Vilvapathy S Karthikeyan  1 , Chikkamoga S Manohar  2 , K Sreelakshmi  3 , Maregowda Shivalingaiah  4
Affiliations
Case Reports

Adrenal Schwannoma: A Rare Incidentaloma

Sumit Kumar et al. J Clin Diagn Res. 2016 Aug.

Abstract

Adrenal schwannomas are very rare tumours that are difficult to diagnose preoperatively. A 42-year-old male presented with epigastric pain and indigestion. He had history of repeated operations for recurrent facial swelling on both sides of face diagnosed as Angiolymphoid Hyperplasia with Eosinophilia (ALHE). Physical examination revealed right facial swelling. Laboratory tests showed no evidence of hormonal hypersecretion. CECT abdomen showed a well-defined heterogenously enhancing right adrenal mass (5x4cm). Patient underwent right adrenalectomy. Histopathology revealed adrenal schwannoma, confirmed by immunohistochemistry (IHC) showing diffuse expression of S-100. Fine-needle aspiration biopsy of facial lesion confirmed ALHE recurrence. Less than 35 cases have been reported. Diagnosis of adrenal schwannoma on imaging studies is very difficult and surgical resection when performed for non-functioning adrenal masses >4cm clinches the diagnosis. Adrenal schwannoma is highly uncommon and was incidentally associated with recurrent ALHE.

Keywords: Adrenalectomy; Angiolymphoid Hyperplasia with Eosinophilia (ALHE); Nodular swellings.

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Figures

[Table/Fig-1]:
[Table/Fig-1]:
Clinical photograph showing multiple preauricular and postauricular nodular swellings. (arrow)
[Table/Fig-2]:
[Table/Fig-2]:
CECT abdomen showing a well-defined heterogeneously enhancing right adrenal mass (arrow) measuring 5x4cm.
[Table/Fig-3]:
[Table/Fig-3]:
Gross appearance of adrenal schwannoma showing globular cystic mass measuring 8x7x3.5cm.
[Table/Fig-4]:
[Table/Fig-4]:
Cut-section of adrenal schwannoma - variegated appearance where solid areas are predominantly yellowish with cystic and haemorrhagic areas.
[Table/Fig-5]:
[Table/Fig-5]:
Photomicrograph: Spindle shaped cells arranged in hyper and hypocellular areas. Cells in hypercellular areas show pallisading arranagement with Verocay body formation. H&E, 100X.
[Table/Fig-6]:
[Table/Fig-6]:
Immunohistochemistry: Spindle cells are strongly and diffusely S100 positive. 40X.
See this image and copyright information in PMC

References

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