CASE REPORT   

Chirurgia 2020 June;33(3):180-3

DOI: 10.23736/S0394-9508.19.05011-3

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Leiomyosarcoma: an unexpected adrenal gland tumor

Daniel O. MONTWEDI ¹ ✉, Victor O. KARUSSEIT ¹, Marissa S. MULLER ²

¹ Department of Surgery, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; ² Department of Anatomical Pathology, National Health Laboratory Service, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa

An adrenal tumor presenting as a flank mass in an adult female is most commonly an adrenocortical carcinoma. Metastases are common and the prognosis poor. We present a case of a 54 year old woman who presented with a right flank mass. On computed tomography a tumor was seen to arise from the adrenal gland. Widespread liver and lung metastases were present. The blood pressure was normal. Preliminary endocrine working was negative. The initial diagnosis was that of an adrenocortical carcinoma. A transcutaneous core needle biopsy revealed a leiomyosarcoma. Endocrine workup was halted. Leiomyosarcoma is a rare adrenal tumor which arises in the central vein of the adrenal gland. Because of the poor prognosis of metastatic leiomyosarcoma, palliative treatment only was offered. Nonendocrine tumors should be considered in the differential diagnosis of an apparently non-functional adrenal mass.

KEY WORDS: Adrenal gland neoplasms; Endocrine gland neoplasms; Leiomyosarcoma; Sarcoma