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Leiomyoma of the Adrenal Gland Presenting as a Non-Functioning Adrenal Incidentaloma: Case Report and Review of the Literature

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Abstract

A 31-year-old woman was incidentally found to have a large right adrenal mass by computed tomography imaging and underwent a workup that included endocrinological evaluation and positron emission tomography imaging. Laboratory results revealed the mass to be non-functioning. Imaging studies revealed a 9-cm heterogeneous mass that was not FDG avid. Because of concern for adrenal cortical carcinoma, the patient underwent a successful right adrenalectomy. Pathology examination demonstrated an 11-cm circumscribed mass consisting of uniform spindle cells without nuclear pleomorphism, necrosis, or mitotic activity. The diagnosis of leiomyoma was supported by a panel of immunohistochemical stains. Adrenal leiomyomas have been reported in the literature, although most are small and not preoperatively suspicious for malignancy. This case illustrates that benign tumors such as leiomyomas, when large and heterogeneous on imaging, can clinically mimic adrenal cortical carcinomas and should be included in the differential diagnosis of adrenal incidentalomas.

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References

  1. NIH. NIH state-of-the-science statement on management of the clinically inapparent adrenal mass (“incidentaloma”). NIH Consens State Sci Statements. 19:1–25, 2002.

    Google Scholar 

  2. Bovio S, Cataldi A, Reimondo G, et al. Prevalence of adrenal incidentaloma in a contemporary computerized tomography series. J Endocrinol Invest 29:298–302, 2006.

    PubMed  CAS  Google Scholar 

  3. Thompson GB, Young WF Jr. Adrenal incidentaloma. Curr Opin Oncol 15:84–90, 2003.

    Article  PubMed  Google Scholar 

  4. Newell-Price J, Grossman A. Adrenal incidentaloma: subclinical Cushing’s syndrome. Postgrad Med J 72:207–10, 1996.

    Article  PubMed  CAS  Google Scholar 

  5. Tsvetov G, Shimon I, Benbassat C. Adrenal incidentaloma: clinical characteristics and comparison between patients with and without extraadrenal malignancy. J Endocrinol Invest 30:647–52, 2007.

    PubMed  CAS  Google Scholar 

  6. Lee JA, Zarnegar R, Shen WT, Kebebew E, Clark OH, Duh QY. Adrenal incidentaloma, borderline elevations of urine or plasma metanephrine levels, and the “subclinical” pheochromocytoma. Arch Surg 142:870–3, 2007, (discussion 73–4).

    Article  PubMed  CAS  Google Scholar 

  7. Arnaldi G, Masini AM, Giacchetti G, Taccaliti A, Faloia E, Mantero F. Adrenal incidentaloma. Braz J Med Biol Res 33:1177–89, 2000.

    Article  PubMed  CAS  Google Scholar 

  8. Chang TH, Lee YC, Liu CC, Huang CH, Wu WJ. Adrenal leiomyoma treated by hand-assisted laparoscopic adrenalectomy: a case report. Kaohsiung J Med Sci 22:575–9, 2006.

    PubMed  Google Scholar 

  9. Chao CS, Zhou ZG, Liao EY. The diagnosis and management of adrenal “incidentaloma”. Zhonghua Nei Ke Za Zhi 33:395–7, 1994.

    PubMed  CAS  Google Scholar 

  10. Dahan H, Beges C, Weiss L, et al. Leiomyoma of the adrenal gland in a patient with AIDS. Abdom Imaging 19:259–61, 1994.

    Article  PubMed  CAS  Google Scholar 

  11. Demirel S, Erk O, Akkaya V, et al. Multiple vascular leiomyomas involving bilateral adrenal glands, spleen, and epicardium, associated with bilateral testicular microlithiasis and empty sella turcica. J Pediatr Surg 32:1365–7, 1997.

    Article  PubMed  CAS  Google Scholar 

  12. Gibbs KE, White A, Kaleya R. Laparoscopic management of an adrenal leiomyoma in an AIDS patient. A case report and review of the literature. JSLS 9:345–8, 2005.

    PubMed  Google Scholar 

  13. Goldman RL, Brodey PA. Symptomatic leiomyoma of the adrenal. Clin Imaging 18:277–8, 1994.

    Article  PubMed  CAS  Google Scholar 

  14. Jacobs IA, Kagan SA. Adrenal leiomyoma: a case report and review of the literature. J Surg Oncol 69:111–2, 1998.

    Article  PubMed  CAS  Google Scholar 

  15. Jimenez-Heffernan JA, Hardisson D, Palacios J, Garcia-Viera M, Gamallo C, Nistal M. Adrenal gland leiomyoma in a child with acquired immunodeficiency syndrome. Pediatr Pathol Lab Med 15:923–9, 1995.

    PubMed  CAS  Google Scholar 

  16. Jurczak F, Hamy A, Paineau J, Courant O, Visset J. An unusual “incidentaloma": adrenal leiomyoma. J Chir (Paris) 131:391, 1994.

    CAS  Google Scholar 

  17. Mouchet F, Ninane J, Gosseye S, et al. Leiomyoma of the suprarenal gland in a child with ataxia-telangiectasia. Pediatr Hematol Oncol 8:235–41, 1991.

    Article  PubMed  CAS  Google Scholar 

  18. Nishida S, Tanimura A, Takasaki S, et al. Surgically resected adrenal leiomyoma: report of a case. Surg Today 25:455–7, 1995.

    Article  PubMed  CAS  Google Scholar 

  19. Parola P, Petit N, Azzedine A, Dhiver C, Gastaut JA. Symptomatic leiomyoma of the adrenal gland in a woman with AIDS. Aids 10:340–1, 1996.

    Article  PubMed  CAS  Google Scholar 

  20. Rosenfeld DL, Girgis WS, Underberg-Davis SJ. Bilateral smooth-muscle tumors of the adrenals in a child with AIDS. Pediatr Radiol 29:376–8, 1999.

    Article  PubMed  CAS  Google Scholar 

  21. Mantero F, Albiger N. A comprehensive approach to adrenal incidentalomas. Arq Bras Endocrinol Metabol 48:583–91, 2004.

    PubMed  Google Scholar 

  22. Ak I, Ozalp S, Yalcin OT, Zor E, Vardareli E. Uptake of 2-[18F]fluoro-2-deoxy-D-glucose in uterine leiomyoma: imaging of four patients by coincidence positron emission tomography. Nucl Med Commun 25:941–5, 2004.

    Article  PubMed  Google Scholar 

  23. Meirelles GS, Ravizzini G, Yeung HW, Akhurst T. Esophageal leiomyoma: a rare cause of false-positive FDG scans. Clin Nucl Med 31:342–4, 2006.

    Article  PubMed  Google Scholar 

  24. Chura JC, Truskinovsky AM, Judson PL, Johnson L, Geller MA, Downs LS Jr. Positron emission tomography and leiomyomas: clinicopathologic analysis of 3 cases of PET scan-positive leiomyomas and literature review. Gynecol Oncol 104:247–52, 2007.

    Article  PubMed  Google Scholar 

  25. Han SJ, Kim TS, Jeon SW, et al. Analysis of adrenal masses by 18F-FDG positron emission tomography scanning. Int J Clin Pract 61:802–9, 2007.

    Article  PubMed  Google Scholar 

  26. Leboulleux S, Dromain C, Bonniaud G, et al. Diagnostic and prognostic value of 18-fluorodeoxyglucose positron emission tomography in adrenocortical carcinoma: a prospective comparison with computed tomography. J Clin Endocrinol Metab 91:920–5, 2006.

    Article  PubMed  CAS  Google Scholar 

  27. Zettinig G, Mitterhauser M, Wadsak W, et al. Positron emission tomography imaging of adrenal masses: (18)F-fluorodeoxyglucose and the 11beta-hydroxylase tracer (11)C-metomidate. Eur J Nucl Med Mol Imaging 31:1224–30, 2004.

    Article  PubMed  Google Scholar 

  28. Radin DR, Kiyabu M. Multiple smooth-muscle tumors of the colon and adrenal gland in an adult with AIDS. AJR Am J Roentgenol 159:545–6, 1992.

    PubMed  CAS  Google Scholar 

  29. Wachsberg RH, Cho KC, Adekosan A. Two leiomyomas of the liver in an adult with AIDS: CT and MR appearance. J Comput Assist Tomogr 18:156–7, 1994.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Departments of Pathology, University of Michigan Health System, 1150 West Medical Center Drive, MSRB-2, C570D, Ann Arbor, MI, 48109-0669, USA

    Jingmei Lin, Matthew J. Wasco & Thomas J. Giordano

  2. Departments of Radiology, University of Michigan Health System, Ann Arbor, MI, USA

    Melvin Korobkin

  3. Departments of Surgery, University of Michigan Health System, Ann Arbor, MI, USA

    Gerard Doherty

Authors
  1. Jingmei Lin
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  2. Matthew J. Wasco
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  3. Melvin Korobkin
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  4. Gerard Doherty
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  5. Thomas J. Giordano
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Correspondence to Thomas J. Giordano.

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Lin, J., Wasco, M.J., Korobkin, M. et al. Leiomyoma of the Adrenal Gland Presenting as a Non-Functioning Adrenal Incidentaloma: Case Report and Review of the Literature. Endocr Pathol 18, 239–243 (2007). https://doi.org/10.1007/s12022-008-9013-7

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  • DOI: https://doi.org/10.1007/s12022-008-9013-7

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