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Yu Y, Li H, Zhang Y. Adenomatoid tumor of the adrenal gland: A case report. Asian J Surg 2024; 47:2801-2802. [PMID: 38383193 DOI: 10.1016/j.asjsur.2024.02.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024] Open
Affiliation(s)
- Yuexin Yu
- Department of Pathology, The First People's Hospital of Zigong, 643099, Zigong, China
| | - Huan Li
- Department of Pathology, The First People's Hospital of Zigong, 643099, Zigong, China; Department of Pathology, Affiliated Hospital of North Sichuan Medical College, 637000, Nɑnchonɡ, China
| | - Yutao Zhang
- Department of Pathology, The First People's Hospital of Zigong, 643099, Zigong, China; Department of Pathology, Affiliated Hospital of North Sichuan Medical College, 637000, Nɑnchonɡ, China.
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2
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Qi HF, Chen LQ, Yang MQ, Li XF, Zhang HN, Zhang KX, Xu HT. Primary adenomatoid tumor of the adrenal gland: A case report and literature review. Medicine (Baltimore) 2023; 102:e36739. [PMID: 38115250 PMCID: PMC10727588 DOI: 10.1097/md.0000000000036739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023] Open
Abstract
RATIONALE Adenomatoid tumors are rare benign tumors, mainly involving the reproductive tract, such as the epididymis in men and the uterus and fallopian tubes in women. However, a few cases can occur outside the reproductive tract. Herein, we report a rare case of a primary adenomatoid tumor of the adrenal gland. PATIENT CONCERNS A 50-year-old man underwent ultrasound examination and was found to have a right adrenal mass without elevated blood pressure, weakness after fatigue, frequent nocturnal urination urgency, pain, or a history of hematuria. The patient's general health was normal. Computed tomography revealed a polycystic mixed-density lesion in the right adrenal region, approximately 7.3 × 4.5 cm in size. DIAGNOSES Based on the clinical information, morphological features, and immunohistochemistry results, a pathological diagnosis of primary adenomatoid tumor of the adrenal gland was made. INTERVENTION Excision of the right adrenal gland and tumor through the 11 ribs. OUTCOMES The patient's postoperative course was uneventful. LESSONS Preventing misdiagnosis adenomatoid tumors with other types of adrenal gland tumors or metastatic tumors is imperative. Morphological and immunohistochemical features can help diagnose primary adenomatoid tumors of the adrenal gland.
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Affiliation(s)
- Hong-Feng Qi
- Department of Thoracic and Cardiac Surgery, Changyi People’s Hospital, Changyi, China
| | - Li-Qian Chen
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, China
| | - Mai-Qing Yang
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, China
| | - Xiu-Feng Li
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, China
| | - Hai-Ning Zhang
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Ke-Xin Zhang
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Hong-Tao Xu
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, China
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3
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Guan J, Zhao C, Li H, Zhang W, Lin W, Tang L, Chen J. Adenomatoid Tumor of the Adrenal Gland: Report of Two Cases and Review of the Literature. Front Endocrinol (Lausanne) 2021; 12:692553. [PMID: 34248850 PMCID: PMC8261242 DOI: 10.3389/fendo.2021.692553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/04/2021] [Indexed: 11/13/2022] Open
Abstract
Adenomatoid tumor (AT) is an uncommon benign neoplasm of mesothelial origin, usually occurring in the female and male genital tracts. Extragenital localization such as the adrenal gland is extremely rare. Until now, only 39 cases of adrenal AT have been reported in the English literature. Here we report two novel cases of adrenal AT that occurred in male patients aged 30 and 31 years. The tumors were discovered incidentally by computed tomography (CT). Macroscopically, the tumors were unilateral and solid, and the greatest dimension of the tumors was 3.5 and 8.0 cm, respectively. Histologically, the tumors consisted of angiomatoid, cystic, and solid patterns and infiltrated the adrenal cortical or medullary tissue. The tumor cells had low nuclear/cytoplasmic ratio, with no pathological mitosis or nuclear pleomorphism. Thread-like bridging strands and signet-ring-like cells could be seen. Immunohistochemically, the tumor cells were positive for epithelial markers (AE1/AE3, CK7) and mesothelial markers (D2-40, calretinin, and WT-1). The Ki-67 index was approximately 1 and 2%, respectively. The differential diagnosis of adrenal AT includes a variety of benign and malignant tumors. The patients had neither local recurrence nor distant metastasis at 21 and 8 months after removal of the tumor. In the literature review, we comprehensively summarized the clinical, morphological, immunohistochemical, and prognostic features of adrenal AT. Adrenal ATs are morphologically and immunophenotypically identical to those that occur in the genital tracts. Combining the histology with immunohistochemical profiles is very supportive in reaching the diagnosis of this benign tumor, helping to avoid misdiagnosis and overtreatment.
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Affiliation(s)
- Jiexia Guan
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Chang Zhao
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hengming Li
- Department of Pathology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Wenjing Zhang
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Weizhen Lin
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Luying Tang
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jianning Chen
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
- *Correspondence: Jianning Chen,
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4
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Ferreira I, De Lathouwer O, Fierens H, Theunis A, André J, de Saint Aubain N. Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque. J Cutan Pathol 2020; 48:128-132. [PMID: 32918316 DOI: 10.1111/cup.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/26/2020] [Accepted: 08/31/2020] [Indexed: 11/26/2022]
Abstract
Adenomatoid tumors are benign tumors of mesothelial origin that are usually encountered in the genital tract. Although they have been observed in other organs, the skin appears to be a very rare location, with only one case reported in the literature to our knowledge. We report a second case of an adenomatoid tumor, arising in the umbilicus of a 44-year-old woman. The patient presented with an 8-month-old erythematous and firm plaque under the umbilicus. A skin biopsy showed numerous microcystic spaces dissecting a fibrous stroma and lined by flattened to cuboidal cells with focal intraluminal papillary formation. This little-known diagnosis constitutes a diagnostic pitfall for dermatopathologists and dermatologists, and could be misdiagnosed as other benign or malignant entities. Through this case report, a practical approach and diagnostic keys have been devised to avoid misdiagnosis and overtreatment.
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Affiliation(s)
- Ingrid Ferreira
- Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier De Lathouwer
- Department of Plastic Surgery, Centre Hospitalier Interrégional Edith Cavell, Brussels, Belgium
| | - Hugues Fierens
- Department of Dermatology, Saint-Jean Hospital, Brussels, Belgium
| | - Anne Theunis
- Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Josette André
- Dermatopathology laboratory, Department of Dermatology, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas de Saint Aubain
- Department of Pathology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
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5
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Duregon E, Volante M, Guzzetti S, Rapa I, Vatrano S, Papotti M. Images in Endocrine Pathology: Unique Composite Adrenal Adenomatoid Tumor, Ganglioneuroma, Myelolipoma, and Cortical Nodular Hyperplasia. Endocr Pathol 2017; 28:276-279. [PMID: 28382483 DOI: 10.1007/s12022-017-9480-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Eleonora Duregon
- Department of Oncology, University of Turin at San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Torino, Italy.
| | - Marco Volante
- Department of Oncology, University of Turin at San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Torino, Italy
| | | | - Ida Rapa
- Department of Oncology, University of Turin at San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Torino, Italy
| | - Simona Vatrano
- Department of Oncology, University of Turin at San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Torino, Italy
| | - Mauro Papotti
- Department of Oncology, University of Turin at San Luigi Hospital, Regione Gonzole 10, 10043 Orbassano, Torino, Italy
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Krstevska B, Mishevska SJ, Jovanovic R. Adenomatoid Tumor of the Adrenal Gland in Young Woman: From Clinical and Radiological to Pathological Study. Rare Tumors 2016; 8:6506. [PMID: 28058099 PMCID: PMC5178849 DOI: 10.4081/rt.2016.6506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 09/13/2016] [Accepted: 09/13/2016] [Indexed: 11/23/2022] Open
Abstract
Adenomatoid tumors are neoplasms of mesothelial origin, usually occurring in the male and female genital tracts. Extragenital localization sites such as adrenal glands are rare but have been reported. When found in the adrenals, they represent great clinical, radiological and pathological diagnostic challenge, with wide range of differential diagnoses to be considered. We present a case of a 30 years old female, with incidental ultrasound finding of unilateral tumor in the right adrenal gland. Multi slices CT scan was of value in localizing this tumor, but not in the precise diagnosis. The tumor ranged from 5.6 cm to 6.4 cm in greatest diameter. Clinical and hormonal examinations excluded Sy. Cushing, M. Conn and pheochromocytoma. The patient underwent laparoscopic right adrenalectomy. A large tumor (d: 8 × 7 × 3 cm) was removed showing no infiltration of the adrenal cortex or medulla, or extra-adrenal extension into the periadrenal adipose tissue. Histological examination showed numerous cystic spaces lined by flattened cubical epithelial cells. The small cystic spaces were separated by edematous fibrovascular stroma with rare epithelial cells with vacuolated cytoplasm. Immunohistochemical staining was positive with vimentin (+), S100 (+), MCA mesothelial Ag (+), CD 68 (+) and negative with acitin (-), CK7 (-), CD3 (-). Adenomatoid tumor is a rare benign neoplasm that should be added in the differential diagnosis of any adrenal tumor occurring in adrenal gland. The histological and immunohistochemical profiles of this adrenal adenomatoid tumor are very supportive in reaching the diagnosis of this benign tumor of a mesothelial cell origin, helping to avoid invasive treatment.
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Affiliation(s)
- Brankica Krstevska
- Clinic of Endocrinology, Diabetes and Metabolic Disorders, Medical Faculty , Skopje
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7
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Taskin OC, Gucer H, Mete O. An Unusual Adrenal Cortical Nodule: Composite Adrenal Cortical Adenoma and Adenomatoid Tumor. Endocr Pathol 2015; 26:370-3. [PMID: 25861051 DOI: 10.1007/s12022-015-9365-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Orhun Cig Taskin
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, Ontario, M5G 2C4, Canada
| | - Hasan Gucer
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, Ontario, M5G 2C4, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
| | - Ozgur Mete
- Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, Ontario, M5G 2C4, Canada.
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
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8
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Phitayakorn R, Maclennan G, Sadow P, Wilhelm S. Adrenal adenomatoid tumor in a patient with human immunodeficiency virus. Rare Tumors 2011; 3:e21. [PMID: 21769320 PMCID: PMC3132125 DOI: 10.4081/rt.2011.e21] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 04/16/2011] [Indexed: 12/04/2022] Open
Abstract
We present the clinical course of a patient with human immunodeficiency virus and an adrenal adenomatoid tumor (AAT). We describe the clinical course and laboratory, radiographic, and microscopic findings of a patient with human immunodeficiency virus (HIV) and an adenomatoid tumor of the right adrenal gland. A review of the literature was also done via electronic searches through PubMed for articles from 1965 to 2008 that contained the following search terms, adenomatoid tumor limited to the English language only. A 22 year-old African-American male with HIV was incidentally found to have a hypermetabolic right adrenal mass. The patient underwent laparoscopic adrenalectomy and the mass had morphological and immunohistochemical features that were consistent with an AAT. A review of the medical literature reveals that almost all cases of AAT were in male patients (96%) with a mean age of 41±11 years (range=22–64) with no significant difference in laterality (right side=46%, left side=50%, unknown=4%). AAT have an average size of 4.2±3.5 cm (range=0.5–14.3 cm). Pre-operative imaging studies do not appear to be able to reliably distinguish AAT from other types of adrenocortical tumors. For reasons that require further research, AAT typically occur in male patients and may be associated with immunosuppression. AAT can be safely removed laparoscopically with no evidence of long-term recurrence even with tumor extension beyond the adrenal capsule.
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Affiliation(s)
- Roy Phitayakorn
- Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
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9
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Adenomatoid tumour of the adrenal gland in a patient with germline SDHD mutation: a case report and review of the literature. Pathology 2011; 43:495-8. [DOI: 10.1097/pat.0b013e3283486bb9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Burton TJ, Azizan EA, Brown MJ. Investigating the function of an aldosterone response pathway in primary human adrenocortical cells obtained from Conn's and phaeochromocytoma patients. Eur J Pharmacol 2011; 657:184-9. [DOI: 10.1016/j.ejphar.2011.01.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 01/06/2011] [Accepted: 01/25/2011] [Indexed: 11/25/2022]
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11
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Alam K, Maheshwari V, Varshney M, Aziz M, Shahid M, Basha M, Gaur K. Adenomatoid tumour of testis. BMJ Case Rep 2011; 2011:2011/mar05_1/bcr0120113790. [PMID: 22707658 DOI: 10.1136/bcr.01.2011.3790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Adenomatoid tumour is a rare neoplasm of mesothelial origin commonly seen in male and female genital tract. In this case report, the authors present a case of adenomatoid tumour in a 35-year-old male who presented with 1-year history of scrotal swelling. A clinical diagnosis of testicular neoplasm was made but final diagnosis of adenomatoid tumour was made after excisional biopsy.
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Affiliation(s)
- Kiran Alam
- Department of Pathology, J.N. Medical College, Aligarh, India
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12
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El-Daly H, Rao P, Palazzo F, Gudi M. A rare entity of an unusual site: adenomatoid tumour of the adrenal gland: a case report and review of the literature. PATHOLOGY RESEARCH INTERNATIONAL 2010; 2010:702472. [PMID: 21151721 PMCID: PMC2990199 DOI: 10.4061/2010/702472] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Accepted: 04/11/2010] [Indexed: 11/20/2022]
Abstract
This is a case report of a 51 year old male who was found to have an incidental left sided non-functioning adrenal mass on routine medical examination and which was confirmed by CT and MRI scans. A laparoscopic left adrenalectomy was done. On gross examination the tumour was a solitary well circumscribed solid-cystic mass with a homogenous pinkish white cut surface. On microscopic examination, the tumour was composed of variably sized tubules and fenestrated channels lined by bland cuboidal cells to epithelioid cells. There was focal extension to capsule and peri-adrenal fat. Immunohistochemically the tumour cells stained with calretinin, Cam5.2, CK7, vimentin and focally with EMA. Ki-67 fraction was <1%. They were negative for ER, CD31, CD34, Factor 8, chromogranin, synaptophysin S100 and inhibin. A diagnosis of an adenomatoid tumour as made. Adenomatoid tumours are rare benign tumours of mesothelial derivation. The adrenal gland is devoid of a mesothelial lining and the most accepted hypothesis for an adenomatoid tumour originating in the adrenal gland is derivation from mesothelial rests. As the adrenal gland is an extremely rare site of occurrence for an adenomatoid tumour, it is frequently mistaken for adrenocortical tumours or a pheochromocytoma clinically and radiologically.
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Affiliation(s)
- H El-Daly
- Histopathology Department, Hammersmith Hospital, The Imperial College of Science, Technology and Medicine, Du Cane Road, London W120HS, UK
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13
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Cystic lymphangioma-like adenomatoid tumor of the adrenal gland: Case presentation and review of the literature. Adv Anat Pathol 2009; 16:424-32. [PMID: 19851133 DOI: 10.1097/pap.0b013e3181bb6c09] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adenomatoid tumors (AT) are usually found in the genital tract of both sexes. They are very rarely located in extragenital sites, and are exceedingly rare in the adrenal. AT of the adrenal gland (AT-AG) are nonfunctioning, usually discovered incidentally and confused on imaging with other more common adrenal neoplasms. The overwhelming majority occur in males. Thirty-four cases have been reported so far, more often presenting grossly as solid tumors, rarely as solid with cystic areas, and 5 cases were almost entirely cystic. At histology they can be either circumscribed or locally infiltrative, and may pose diagnostic difficulties when the pathologist relies on morphology alone or is challenged on frozen section. On light microscopy the diagnosis may be very difficult if the tumor is rich in vacuolated cells, mimicking metastatic signet ring-cell adenocarcinoma. Immunophenotyping and/or electron microscopy are paramount in helping to ascertain their mesothelial lineage. Lymphangioma is the main histologic mimic of solid-cystic and cystic AT-AG, but lymphangioma is immunopositive for endothelial markers and negative for cytokeratins and mesothelial markers. Ultrastructural analysis has been performed in 10 published cases of AT-AG, in all of which the classical microvilli of coelomic type were always observed. In brief we report herein the sixth case of cystic lymphangioma-like AT, which was incidentally discovered during clinical follow-up in a 39-year-old man undergoing cancer staging and surveillance after surgery. The adrenal tumor was 5.5 cm in size and was fully investigated immunohistochemically and ultrastructurally. A complete review of the literature is also presented.
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14
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Expression of the epithelial Na(+) channel and other components of an aldosterone response pathway in human adrenocortical cells. Eur J Pharmacol 2009; 613:176-81. [PMID: 19371736 DOI: 10.1016/j.ejphar.2009.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 03/19/2009] [Accepted: 04/01/2009] [Indexed: 11/21/2022]
Abstract
We have unexpectedly found expression of the epithelial Na(+) channel (ENaC) in human adrenocortical cells and tested the hypothesis that these cells contain the components of an aldosterone response pathway. Tissue was obtained from patients undergoing adrenalectomy and mRNA and protein expression of recognised components of an aldosterone-response pathway were determined by RT-PCR and Western blotting. The effects of mineralocorticoid receptor agonists and antagonists, amiloride analogues, and extracellular Na(+) on basal and stimulated aldosterone release from immortalised (H295R) cells were determined by radioimmunoassay. Expression of mRNA for alpha-, beta- and gamma-subunits of ENaC, the mineralocorticoid receptor, Nedd4L, Sgk1 and 11beta hydroxysteroid dehydrogenase type II was confirmed in human adrenal cortex. Using Western blotting alpha-, beta- and gamma-ENaC expression was demonstrated in adrenocortical cells. Measurements of 24 h aldosterone release from H295R cells showed stimulation by K(+) and angiotensin II, suppression by both Na(+) and high-concentration 5-(N-ethyl-N-isopropyl) amiloride (EIPA, blocker of Na(+)-H(+) exchange) and no change with benzamil (ENaC blocker). (22)Na-uptake into H295R cells was inhibited by EIPA, but not by benzamil. Our experiments suggest that the components of an aldosterone response pathway are present in human adrenal cortex. Studies in H295R cells, however, suggest that ENaC is not an important mediator of (22)Na-uptake or aldosterone production. Further studies are required to determine the importance of an adrenal aldosterone response pathway.
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15
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Timonera ER, Paiva ME, Lopes JM, Eloy C, van der Kwast T, Asa SL. Composite adenomatoid tumor and myelolipoma of adrenal gland: report of 2 cases. Arch Pathol Lab Med 2008; 132:265-7. [PMID: 18251587 DOI: 10.5858/2008-132-265-catamo] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2007] [Indexed: 11/06/2022]
Abstract
Adenomatoid tumor and myelolipoma are benign, hormonally inactive tumors that are often incidental findings in the adrenal glands. Myelolipoma is more common than adenomatoid tumor in this location but both are rare, and as yet, the pathogenesis of both remains unclear. We report 2 cases of composite adenomatoid tumor and myelolipoma, incidentally found in the adrenal gland on investigation for other diseases. To our knowledge, composite adenomatoid tumor and myelolipoma of adrenal gland has not been previously reported.
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Affiliation(s)
- Elizabeth R Timonera
- Department of Pathology, University Health Network, University of Toronto, Ontario, Canada M5G 2C4
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16
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Hamamatsu A, Arai T, Iwamoto M, Kato T, Sawabe M. Adenomatoid tumor of the adrenal gland: case report with immunohistochemical study. Pathol Int 2005; 55:665-9. [PMID: 16185299 DOI: 10.1111/j.1440-1827.2005.01887.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Adrenal adenomatoid tumor (AT) is a recently recognized disease with marked male predominance. Herein is presented a case of adrenal AT incidentally found in a 30-year-old man and results of immunohistochemical examination of the tumor. The left adrenal gland, weighing 17 g, contained a mass measuring 3 x 2.5 x 2.5 cm in the cortical tissue. Cut surface showed a relatively well-circumscribed firm tumor with a white solid appearance. Histologically, the tumor had the typical appearance of AT described in the genital tract. Immunohistochemically, the tumor cells were positive for calretinin, D2-40, WT1, mesothelial cell antigen, CA125, thrombomodulin, vimentin and cytokeratins (stained by AE1 + AE3, OV-TL 12/30, CAM5.2 and MNF116), and negative for endothelial markers (CD31, CD34 and factor VIII-related antigen) and CD56. CD56-positive adrenocortical cells were diffusely scattered in the tumor, especially in its periphery. Immunohistochemistry of estrogen, progesterone and androgen receptors was negative. These findings confirm mesothelial origin of the tumor and suggest that this tumor has little relation to sex hormone despite male predominance.
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Affiliation(s)
- Akihiko Hamamatsu
- Department of Forensic Pathology, Tokyo Medical Examiner's Office, Japan
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17
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Fan SQ, Jiang Y, Li D, Wei QY. Adenomatoid tumour of the left adrenal gland with concurrent left nephrolithiasis and left kidney cyst. Pathology 2005; 37:398-400. [PMID: 16194858 DOI: 10.1080/00313020500252721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Burel-Vandenbos F, Cardot-Leccia N, Effi B, Varini JP, Saint-Paul MC, Michiels JF. Une tumeur inhabituelle de la surrénale. Ann Pathol 2005; 25:386-8. [PMID: 16498291 DOI: 10.1016/s0242-6498(05)80146-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Adenomatoid tumors are benign mesothelial tumors that usually affect the genital tract. We report the case of a 65-year-old man with an adenomatoid tumor of the adrenal gland. This uncommon location and its histological heterogeneity can lead to a mistaken diagnosis of malignant tumor. Positive cells with mesothelial markers in immunohistochemistry improve diagnosis. The proper identification of this benign tumor in the adrenal gland and the knowledge of its differential diagnosis deserve attention to avoid invasive treatment.
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Affiliation(s)
- Fanny Burel-Vandenbos
- Service d'Anatomie Pathologique, Hôpital Pasteur, 30 avenue de la voie romaine, 06000 Nice.
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19
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Varkarakis IM, Mufarrij P, Studeman KD, Jarrett TW. Adenomatoid of the adrenal gland. Urology 2005; 65:175. [PMID: 15667895 DOI: 10.1016/j.urology.2004.08.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2004] [Accepted: 08/18/2004] [Indexed: 11/22/2022]
Abstract
Adenomatoid tumors are common in the genital tract but rare in the adrenal gland. These tumors can be difficult to diagnose when present in extragenital sites. This type of adrenal tumor lacks specific radiographic features and can be confused preoperatively with more common adrenal gland tumors. We present the case of a 54-year-old man with an incidental right adrenal mass with calcified components and elevated urinary levels of homovanillic acid that was found to be an adenomatoid tumor of the adrenal gland.
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Affiliation(s)
- Ioannis M Varkarakis
- Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Garg K, Lee P, Ro JY, Qu Z, Troncoso P, Ayala AG. Adenomatoid tumor of the adrenal gland: a clinicopathologic study of 3 cases. Ann Diagn Pathol 2005; 9:11-5. [PMID: 15692945 DOI: 10.1053/j.anndiagpath.2004.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Adenomatoid tumors are relatively uncommon benign neoplasms of mesothelial origin, usually occurring in the male and female genital tracts. Rare extragenital adenomatoid tumors have been identified in the adrenal glands, heart, mesentery, pleura, and lymph nodes. In the adrenal gland, adenomatoid tumors may pose a diagnostic challenge. The differential diagnosis includes adrenocortical carcinoma and metastatic carcinoma, especially signet ring cell carcinoma. Because of its glandular pattern, an adenomatoid tumor may be confused with an adenocarcinoma. We present 3 cases of adrenal adenomatoid tumors, including one with a concurrent large hemorrhagic vascular adrenal cyst. The adenomatoid tumors were unilateral, appeared solid and white, and varied from 1.7 to 4.2 cm in diameter. They occurred in 3 male patients aged 33, 33, and 46 years. One patient presented with abdominal pain due to the presence of a concurrent large adrenal cyst. The tumor was an incidental radiological finding in another case and was discovered during the course of a workup for hypertension in the third case. The light microscopic appearances were consistent with those of typical adenomatoid tumors. Immunohistochemical stains for calretinin and cytokeratin 5/6 were positive, confirming the tumors' mesothelial origin. Ultrastructural studies performed in 2 cases revealed microvilli and desmosomes. Follow-up showed no evidence of recurrence or metastasis. In our experience, the key to the diagnosis of this rare benign tumor is to consider adenomatoid tumor in the differential diagnosis of any glandular tumor occurring in the adrenal gland.
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Affiliation(s)
- Karuna Garg
- Department of Pathology, Health Science Center, University of Texas, Houston, TX 77030-4009, USA
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