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Yin H, Zhang Y, Wu L, Zhang J. Imaging findings of primary epithelioid sarcoma of adrenal gland: a case report and literature review. Front Oncol 2023; 13:1015258. [PMID: 37256180 PMCID: PMC10225629 DOI: 10.3389/fonc.2023.1015258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/20/2023] [Indexed: 06/01/2023] Open
Abstract
Epithelioid sarcoma (ES) is a rare soft tissue malignant tumor with an uncertain histogenetic origin. It usually arises in soft tissues of the extremities, while ES in adrenal gland is extremely rare. There is no special clinical manifestation in the early stage, so it may be misdiagnosed and delay the treatment. We reported a 69-year-old male with an adrenal ES. The tumor was completely resected, and two months later, positron emission tomography-computed tomography(PET/CT) noted recurrence at the tumor bed and multiple metastases. The patient has been treated with chemotherapy with good effects. We summarize the radiological findings and immunohistochemical indexes of primary epithelioid sarcoma of adrenal gland, which may be useful to promote disease awareness and help to distinguish among other lesions.
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Affiliation(s)
- Hongyu Yin
- Graduate School of Dalian Medical University, Dalian, Liaoning, China
| | - Yi Zhang
- Department of Radiology, Jiangsu Taizhou People’s Hospital, Taizhou, Jiangsu, China
| | - Linyun Wu
- Taizhou Polytechnic College, Taizhou, Jiangsu, China
| | - Ji Zhang
- Department of Radiology, Jiangsu Taizhou People’s Hospital, Taizhou, Jiangsu, China
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Brodie Z, McCartney E, Toledo S. An Adrenal SMARCB1/INI1 Deficient Proximal Epithelioid Sarcoma in a Middle-Aged Female: A Case Report. Cureus 2022; 14:e29242. [PMID: 36262954 PMCID: PMC9573787 DOI: 10.7759/cureus.29242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2022] [Indexed: 12/04/2022] Open
Abstract
Proximal epithelioid sarcomas are rare soft tissue sarcomas that have been documented in a diverse range of presentations. However, there have been few cases describing adrenal presentations. These neoplasms are thought to be driven by a loss of SWItch/sucrose non-fermentable (SWI/SNF)-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1 (SMARCB1), also known as integrase interactor 1 (INI1). SMARCB1/INI1 is a tumor suppressor gene thought to play a role in multiple malignancies with varying degrees of gene expression. Complete loss of SMARCB1/INI1 has most commonly been described in the English scientific literature as malignant rhabdoid tumors of renal origin within pediatric populations and proximal epithelioid sarcomas in adult populations. We describe a case of a primary adrenal proximal epithelioid sarcoma demonstrating complete loss of SMARCB1/INI1 in a middle-aged adult female.
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Alturkustani M, Schmidt R, Gayer C, Warren M, Navid F, Raca G, Biegel JA, Pawel B, Zhou S. Primary Adrenal Malignant Rhabdoid Tumor in a 14-Year-Old Female: A Case Report and Literature Review. Int J Surg Pathol 2021; 30:172-176. [PMID: 34106024 DOI: 10.1177/10668969211024331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Malignant rhabdoid tumor (MRT) is a rare, SWItch/sucrose nonfermentable-related matrix-associated actin-dependent regulator of chromatin subfamily B member 1 (SMARCB1)-deficient, aggressive tumor, occurring predominantly in children below 3 years of age. Primary adrenal MRT is extremely rare, with only 3 cases reported in the literature. A previously healthy 14-year-old female presented with left upper quadrant/epigastric abdominal pain. Imaging studies revealed an 8.0 × 8.0 × 6.5 cm, heterogeneous, partially enhancing mass along the superior margin of the left kidney encasing the adrenal gland. Surgical resection of the tumor revealed a hypercellular heterogeneous neoplasm arising from the adrenal gland. It was composed predominantly of primitive small round blue cells with focal true rosettes and areas of vague glandular epithelial differentiation and chondroid differentiation. Classic rhabdoid-type cytoplasmic inclusions were focally present. Mitoses, tumor necrosis, and hemorrhage were readily seen. Tumor cells showed complete loss of SMARCB1 (INI1) nuclear staining, demonstrated strong, and diffuse positivity for glypican 3, patchy positivity for CD99, cytokeratin, Sal-like protein 4, Lin-28 homolog A, epithelial membrane antigen, and S100. Molecular studies revealed biallelic frameshift mutations in the SMARCB1 gene (c.673delG and c.683dupT) without pathogenic copy number aberrations. The histologic, immunohistochemical, and molecular findings support a diagnosis of MRT. The unusual age, location, and mutations of this case expand the clinicopathologic and molecular spectrum of MRT.
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Affiliation(s)
- Murad Alturkustani
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,37848King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ryan Schmidt
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Christopher Gayer
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Mikako Warren
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Fariba Navid
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Gordana Raca
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Jaclyn A Biegel
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Bruce Pawel
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
| | - Shengmei Zhou
- Children's Hospital Los Angeles, Los Angeles, CA, USA.,Keck School of Medicine, 12223University of Southern California, Los Angeles, CA, USA
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