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Case Reports
. 2025 Mar 20;17(3):e80891.
doi: 10.7759/cureus.80891. eCollection 2025 Mar.

Unraveling Adrenal Oncocytoma: Clinical Presentation, Diagnosis, and Surgical Success

Arjun N  1 , Dinesh Anne  1 , Bhavya Shetty  1 , Murali Velagapudi  1 , Nirupam Nadella  2
Affiliations
Case Reports

Unraveling Adrenal Oncocytoma: Clinical Presentation, Diagnosis, and Surgical Success

Arjun N et al. Cureus. .

Abstract

Adrenal oncocytomas are rare benign tumors originating in the adrenal gland and feature eosinophilic, mitochondria-rich cytoplasm. These tumors are difficult to diagnose and manage since they develop infrequently and have nonspecific symptoms. We present the case of a 45-year-old male with no known comorbidities who came with complaints of nonspecific on-off abdominal pain and no other associated findings. Imaging indicated a 12 × 10 cm mass originating from the right adrenal gland, abutting the right kidney, with no involvement of major arteries. Biochemical studies suggested a non-functioning adrenal tumor with Adrenocortical Carcinoma and non-functioning Pheochromocytoma as differentials. The patient underwent a right laparoscopic adrenalectomy with the tumor not invading any other structures. The patient had an uneventful postoperative period. The histopathology exam revealed an adrenal mass with predominant oncocytoma features. The patient had an uneventful postoperative period. The diagnosis of adrenal oncocytoma has been established by histopathological analysis. This report underscores the significance of histological confirmation in adrenal tumors and the need for additional research to provide diagnostic and treatment guidelines for these uncommon neoplasms, given the limited number of reported cases.

Keywords: adrenal oncocytoma; adrenal tumor management; eosinophilic cytoplasm; laparoscopic adrenalectomy; oncocytic cells.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Sub-Committee of Sapthagiri Institute of Medical Sciences and Research, Bangalore issued approval I.E.S.C/102/2024. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Gross pathology of adrenal oncocytoma: macroscopic characteristics
Gross specimen of adrenal oncocytoma demonstrating a well-circumscribed, yellowish-brown tumor with a homogeneous cut surface and focal areas of hemorrhage.
Figure 2
Figure 2. Histological features of adrenal oncocytoma showing oncocytic cell proliferation
Hematoxylin and eosin-stained histological section of adrenal oncocytoma, demonstrating sheets of oncocytic cells with abundant granular, eosinophilic cytoplasm. The nuclei are uniform, round to oval, and show occasional prominent nucleoli. The section highlights areas with preserved tumor architecture and mild cytoplasmic granularity.
Figure 3
Figure 3. Histopathological features of adrenal oncocytoma: high-power view
A hematoxylin and eosin-stained section of adrenal oncocytoma shows oncocytic cells with abundant eosinophilic, granular cytoplasm, and centrally located round nuclei.
Figure 4
Figure 4. Histological features of adrenal oncocytoma with fibrous stromal component
Hematoxylin and eosin-stained histological section of adrenal oncocytoma illustrating a fibrous stromal band traversing the tumor. The oncocytic cells, with abundant eosinophilic and granular cytoplasm, are seen at the periphery, while the central area consists of dense, collagenous stroma. Tumor cells are arranged in solid nests and cords with round to oval nuclei.
See this image and copyright information in PMC

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