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Case Reports
. 2018 Mar;9(1):83-85.
doi: 10.1007/s13193-017-0715-5. Epub 2017 Nov 9.

Adrenal Schwannoma Treated with Open Adrenalectomy: a Case Report

Prakash Hebbulse Shivalingaiah  1   2 , Pradeep Kumar  3 , Suyash Bajoria  3
Affiliations
Case Reports

Adrenal Schwannoma Treated with Open Adrenalectomy: a Case Report

Prakash Hebbulse Shivalingaiah et al. Indian J Surg Oncol. 2018 Mar.

Abstract

Adrenal schwannomas are very rare tumors accounting for only 0.2% of the adrenal tumors. These are very difficult to diagnose preoperatively and usually present as incidental non-secreting adrenal masses in asymptomatic patients or in patients with non-specific complaints. Computed tomography (CT) and magnetic resonance imaging (MRI) are required to aid the diagnosis, but adrenal schwannomas cannot be distinguishably confirmed on the basis of imaging alone. Histopathological examination (HPE) is essential for accurate diagnosis. We report a rare case of a right adrenal schwannoma in a 68-year-old man. The clinical evaluation was unremarkable and the radiological examination revealed a suprarenal mass lesion on ultrasonography (USG). CT revealed a right adrenal mass which was purported to be likely malignant. Right adrenalectomy was performed by the open approach along with excision of the surrounding enlarged lymph nodes. The postoperative course was uneventful. HPE established the adrenal mass to be a schwannoma, a benign tumor arising from Schwann cells, an exceedingly unusual occurrence in the adrenal glands. A non-secreting adrenal mass can be easily misjudged and the exact diagnosis of the lesion cannot be made sure of without both radiologic and pathologic confirmation. Unilateral adrenal primary or metastatic lesions need pathological confirmation as it can dramatically affect prognosis. Unusual tumors of the adrenal gland like schwannomas may be found incidentally or otherwise and will generate difficulties in establishing the right management. Complete excision is the treatment of choice whenever feasible and will also clarify pathology.

Keywords: Adrenal tumor; Incidentaloma; Schwannoma.

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Figures

Fig. 1
Fig. 1
Abdomen CT scan shows well-defined mass lesion in suprarenal area
Fig. 2
Fig. 2
Grass photograph of adrenal tumor—cross-section shows yellowish white color
Fig. 3
Fig. 3
Histologically tumor was composed of spindle-shaped cells arranged in fascicles with intervening hypocellular areas
Fig. 4
Fig. 4
S-100 protein diffuse positivity seen in IHC
See this image and copyright information in PMC

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