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A Mimic of Sarcomatoid Adrenal Cortical Carcinoma: Epithelioid Angiosarcoma Occurring in Adrenal Cortical Adenoma

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Abstract

The adrenal gland is a site of various neoplasms; however, it is rarely involved by sarcomas. We present herein an unusual adrenal neoplasm consisting of epithelioid angiosarcoma and adrenal cortical adenoma. In this report, the authors highlight the diagnostic challenges associated with an epithelioid angiosarcoma occurring in an adrenal cortical neoplasm by providing a comprehensive discussion on the spectrum of vascular proliferations seen in the adrenal gland along with a roadmap for practicing pathologists. The presence of angiosarcoma within an adrenal cortical adenoma may represent a collision tumor; however, one can speculate that the rich vasculature of endocrine lesions can also create a favorable milieu for the occurrence of this phenomenon. While the latter needs to be further clarified, the presented case should be added to the unusual clinical presentations of vascular lesions of the adrenal gland mimicking a sarcomatoid adrenal cortical carcinoma.

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References

  1. Fletcher CDM, Bridge J, Hogendoom PCW, Mertens F (Eds): WHO classification of Tumours of Soft Tissue and Bone. IARC: Lyon, 2013.

    Google Scholar 

  2. Kefeli M, Mete O. An unusual malignant thyroid nodule: coexistence of epithelioid angiosarcoma and follicular variant papillary thyroid carcinoma. Endocr Pathol 2013 Apr 23.

  3. Criscuolo M, Valerio J, Gianicolo ME, Gianicolo EA, Portaluri M. A vinyl chloride-exposed worker with an adrenal gland angiosarcoma: a case report. Ind Health 52:66–70, 2014.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Kędzierski L, Hawrot-Kawecka A, Holecki M, Duława J. Angiosarcoma of the adrenal gland. Pol Arch Med Wewn. 123:502–503, 2013.

    PubMed  Google Scholar 

  5. Sebastiano C, Zhao X, Deng FM, Das K. Cystic lesions of the adrenal gland: our experience over the last 20 years. Hum Pathol. 44:1797–803, 2013.

    Article  PubMed  Google Scholar 

  6. Sung JY, Ahn S, Kim SJ, Park YS, Choi YL. Angiosarcoma arising within a long-standing cystic lesion of the adrenal gland: a case report. J Clin Oncol 31:e132-6, 2013.

    Article  PubMed  Google Scholar 

  7. Derlin T, Clauditz TS, Habermann CR. Adrenal epithelioid angiosarcoma metastatic to the epicardium: diagnosis by 18F-FDG PET/CT. Clin Nucl Med 37:914–915, 2012.

    Article  PubMed  Google Scholar 

  8. Lepoutre-Lussey C, Rousseau A, Al Ghuzlan A, Amar L, Hignette C, Cioffi A, Zinzindohoué F, Leboulleux S, Plouin PF. Primary adrenal angiosarcoma and functioning adrenocortical adenoma: an exceptional combined tumor. Eur J Endocrinol 166:131–135, 2012.

    Article  CAS  PubMed  Google Scholar 

  9. Schreiner AM, Hoda RS. Primary adrenal epithelioid angiosarcoma showing rhabdoid morphology on air-dried smears. Diagn Cytopathol 40 Suppl 2:E162-4, 2012.

  10. Gambino G, Mannone T, Rizzo A, Scio A, Branca M, Airò Farulla M, Guccione M,Spallitta IS, Nicoli N. Adrenal epithelioid angiosarcoma: a case report. Chir Ital 60:463–467, 2008.

    PubMed  Google Scholar 

  11. Galmiche L, Morel HP, Moreau A, Labrosse PA, Coindre JM, Heymann MF. Primary adrenal angiosarcoma. Ann Pathol 24:371–373, 2004.

    Article  PubMed  Google Scholar 

  12. Tousi-Sadr HR, Lam GW. Angiosarcoma of the adrenal gland. Ugeskr Laeger 164:911–912, 2002.

    PubMed  Google Scholar 

  13. Krüger S, Kujath P, Johannisson R, Feller AC. Primary epithelioid angiosarcoma of the adrenal gland case report and review of the literature. Tumori 87:262–265, 2001.

    PubMed  Google Scholar 

  14. Croitoru AG, Klausner AP, McWilliams G, Unger PD. Primary epithelioid angiosarcoma of the adrenal gland. Ann Diagn Pathol 5:300–303, 2001.

    Article  CAS  PubMed  Google Scholar 

  15. Ben-Izhak O, Auslander L, Rabinson S, Lichtig C, Sternberg A. Epithelioid angiosarcoma of the adrenal gland with cytokeratin expression. Report of a case with accompanying mesenteric fibromatosis. Cancer 69:1808–1812, 1992.

    Article  CAS  PubMed  Google Scholar 

  16. Al-Meshan MK, Katchy KC. An unusual angiosarcoma. A case report. Med Princ Pract 13:295–297, 2004.

    Article  CAS  PubMed  Google Scholar 

  17. Wenig BM, Abbondanzo SL, Heffess CS. Epithelioid angiosarcoma of the adrenal glands. A clinicopathologic study of nine cases with a discussion of the implications of finding “epithelial-specific” markers. Am J Surg Pathol 18:62–73, 1994.

    Article  CAS  PubMed  Google Scholar 

  18. Pasqual E, Bertolissi F, Grimaldi F, Beltrami CA, Scott CA, Bacchetti S, Waclaw BU, Cagol PP. Adrenal angiosarcoma: report of a case. Surg Today 32:563–565, 2002.

    Article  PubMed  Google Scholar 

  19. Kareti LR, Katlein S, Siew S, Blauvelt A. Angiosarcoma of the adrenal gland. Arch Pathol Lab Med 112:1163–1165, 1988.

    CAS  PubMed  Google Scholar 

  20. Sidoni A, Magro G, Cavaliere A, Scheibel M, Bellezza G. Primary adrenal angiosarcoma. Pathologica 95:60–63, 2003.

    CAS  PubMed  Google Scholar 

  21. Ferrozzi F, Tognini G, Bova D, Zuccoli G, Pavone P. Hemangiosarcoma of the adrenal glands: CT findings in two cases. Abdom Imaging 26:336–339, 2001.

    Article  CAS  PubMed  Google Scholar 

  22. Livaditou A, Alexiou G, Floros D, Filippidis T, Dosios T, Bays D. Epithelioid angiosarcoma of the adrenal gland associated with chronic arsenical intoxication? Pathol Res Pract187(2–3):284–9, 1991.

    Article  CAS  PubMed  Google Scholar 

  23. Dekou A, N’dah JK, Kouame B, Kohou L, Abroulaye F, Gowe E, Kassanyou S, ManzanK. Primary leiomyosarcoma of adrenal gland, in black African woman: diagnosis and therapeutically aspects. Prog Urol 23:421–4, 2013.

    Article  CAS  PubMed  Google Scholar 

  24. Kimura N, Watanabe T, Fukase M, Wakita A, Noshiro T, Kimura I. Neurofibromin and NF1 gene analysis in composite pheochromocytoma and tumors associated with von Recklinghausen’s disease. Mod Pathol 15:183–8, 2002.

    Article  PubMed  Google Scholar 

  25. Mete O, Tischler AS, de Krijger R, McNicol AM, Eisenhofer G, Pacak K, Ezzat S, Asa SL. Protocol for the examination of specimens from patients with pheochromocytomas and extra-adrenal paragangliomas. Arch Pathol Lab Med138:182–8, 2014.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Thway K, Olmos D, Shah C, Flora R, Shipley J, Fisher C. Oncocytic adrenal cortical carcinosarcoma with pleomorphic rhabdomyosarcomatous metastases. Am J Surg Pathol 36:470–6, 2012.

    Article  PubMed  Google Scholar 

  27. de Krijger RR, Papathomas TG. Adrenocortical neoplasia: evolving concepts in tumorigenesis with an emphasis on adrenal cortical carcinoma variants. Virchows Arch 460:9–18, 2012.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Kao CS, Grignon DJ, Ulbright TM, Idrees MT. A case report of adrenocortical carcinosarcoma with oncocytic and primitive neuroectodermal-like features. Hum Pathol44:1947–55, 2013.

    Article  PubMed  Google Scholar 

  29. Carstens HB, Ghadially FN, Henderson DW, Stirling JW. Case for the panel. Weibel-Palade body-like lamellar structure in angiosarcoma. Ultrastruct Pathol 19:137–43, 1995.

    Article  CAS  PubMed  Google Scholar 

  30. Białas M, Szczepański W, Szpor J, Okoń K, Kostecka-Matyja M, Hubalewska-Dydejczyk A, Tomaszewska R. Adenomatoid tumour of the adrenal gland: a case report and literature review. Pol J Pathol 61:97–102, 2010.

    PubMed  Google Scholar 

  31. Rossi S, Orvieto E, Furlanetto A, Laurino L, Ninfo V, Dei Tos AP. Utility of the immunohistochemical detection of FLI-1 expression in round cell and vascular neoplasm using a monoclonal antibody. Mod Pathol 17:547–52, 2004.

    Article  CAS  PubMed  Google Scholar 

  32. Cuda J, Mirzamani N, Kantipudi R, Robbins J, Welsch MJ, Sundram UN. Diagnostic utility of Fli-1 and D2-40 in distinguishing atypical fibroxanthoma from angiosarcoma. Am J Dermatopathol 35:316–18, 2013.

    Article  PubMed  Google Scholar 

  33. Naka N, Ohsawa M, Tomita Y, Kanno H, Uchida A, Aozasa K. Angiosarcoma in Japan. A review of 99 cases. Cancer 75:989–96, 1995.

    Article  CAS  PubMed  Google Scholar 

  34. Schaeffer M, Hodson DJ, Lafont C, Mollard P. Endocrine cells and blood vessels work in tandem to generate hormone pulses. J Mol Endocrinol 47:59–66, 2011.

    Article  Google Scholar 

  35. Turner HE, Harris AL, Melmed S, Wass JA. Angiogenesis in endocrine tumors. Endocr Rev 24:600–32, 2003.

    Article  CAS  PubMed  Google Scholar 

  36. Aozasa K, Naka N, Tomita Y, Ohsawa M, Kanno H, Uchida A, Ono K. Angiosarcoma developing from chronic pyothorax. Mod Pathol 7:906–11, 1994.

    CAS  PubMed  Google Scholar 

  37. Schneider T, Renney J, Hayman J. Angiosarcoma occurring with chronic osteomyelitis and residual foreign material: case report of a late World War II wound complication. Aust N Z J Surg 67:576–8, 1997.

    Article  CAS  PubMed  Google Scholar 

  38. Schmitz BA, Singh C, Gulbahce HE, Manivel JC, Pambuccian SE. Florid capsular and pericapsular papillary endothelial proliferation associated with poorly differentiated thyroid carcinoma. Int J Surg Pathol 19:110–2, 2011.

    PubMed  Google Scholar 

  39. Petronella P, Scorzelli M, Luise R, Iannaci G, Sapere P, Ferretti M, Costanzo RM, Freda F, Canonico S, Rossiello R. Primary thyroid angiosarcoma: an unusual localization. World J Surg Oncol 3;10:73, 2012.

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Authors and Affiliations

  1. Department of Pathology, University Health Network, 200 Elizabeth Street, 11th floor, Toronto, ON, M5G2C4, Canada

    Toshitetsu Hayashi, Hasan Gucer & Ozgur Mete

  2. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada

    Ozgur Mete

Authors
  1. Toshitetsu Hayashi
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  2. Hasan Gucer
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  3. Ozgur Mete
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Correspondence to Ozgur Mete.

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Hayashi, T., Gucer, H. & Mete, O. A Mimic of Sarcomatoid Adrenal Cortical Carcinoma: Epithelioid Angiosarcoma Occurring in Adrenal Cortical Adenoma. Endocr Pathol 25, 404–409 (2014). https://doi.org/10.1007/s12022-014-9330-y

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