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Imaging findings of adrenal primitive neuroectodermal tumors: a series of seven cases

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Abstract

Objective

To explore the imaging features of adrenal primitive neuroectodermal tumors (PNETs).

Materials and methods

This retrospective study included seven patients with surgically and pathologically confirmed adrenal PNETs. Among them, six underwent computed tomography (CT) scans, and one underwent magnetic resonance imaging. The imaging findings, including size, shape, margin, hemorrhage, calcification, cystic degeneration, regional lymph nodes involvement, tumor thrombus formation and enhancement pattern, were retrospectively analyzed.

Results

Among the seven adrenal PNET patients, six were male, and one was female. The median age was 26 years (range 2–56 years). The disease generally presented with either insidious symptoms (n = 4) or non-specific symptoms, including right flank pain (n = 1) and left upper abdominal discomfort (n = 2). On the pre-enhanced CT images, the tumor usually appeared as a well-defined, rounded or oval, heterogeneous mass without calcification. Certain tissue characteristics, such as cystic degeneration (n = 5), capsule (n = 4) and hemorrhage (n = 2), were observed. Regional lymph node involvement was observed in three cases, and renal vein thrombus was observed in one case. All cases showed mild heterogeneous enhancement of the tumor on the enhanced CT images.

Conclusion

An adrenal PNET commonly presents as a relatively large, well-defined, heterogeneous mass with cystic degeneration, necrosis and a characteristic mild contrast-enhancement pattern on multiphase enhanced images. PNET should be considered when the diagnosis of common tumors is not favored by signs on images.

Clinical Trial Registration Statement

This study was approved by the medical ethics committee of Xiangya Hospital, Central South University. The approval number is 201512538.

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Acknowledgements

This study was supported by the Freedom Exploration Program of Central South University (No. 2011QNZT153) and Natural Science Foundation of Hunan Province (No. 14JJ6001).

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Author notes

    Authors and Affiliations

    1. Department of Radiology, Xiangya Hospital, Central South University, 87# XiangYa Road, Changsha, 410008, Hunan, People’s Republic of China

      Y. Zhang, X. Yi, W. Liu & W. Li

    2. Imaging Diagnosis and Interventional Center, Sun Yat-sen University Cancer Center, Guangzhou, People’s Republic of China

      P. Cai & L. Li

    3. Department of Ultrasonography, Xiangya Hospital, Central South University, Hunan, People’s Republic of China

      M. Chen

    4. Department of Pathology, Xiangya Hospital, Central South University, Hunan, People’s Republic of China

      D. Xiao

    5. Departments of General Surgery, Xiangya Hospital, Central South University, Hunan, People’s Republic of China

      Y. Li

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    1. Y. Zhang
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    Corresponding author

    Correspondence to X. Yi.

    Ethics declarations

    Ethical standards

    This study was conducted in accordance with the Declaration of Helsinki, all its amendments, and national regulations. This retrospective study was approved by the hospital’s Institutional Review Board. Written or verbal informed consent was obtained from all patients.

    Conflict of interest

    None of the authors has declared any conflict of interest.

    Additional information

    Y. Zhang, P. Cai and M. Chen contributed equally to this work.

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    Cite this article

    Zhang, Y., Cai, P., Chen, M. et al. Imaging findings of adrenal primitive neuroectodermal tumors: a series of seven cases. Clin Transl Oncol 19, 641–649 (2017). https://doi.org/10.1007/s12094-016-1580-3

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    • DOI: https://doi.org/10.1007/s12094-016-1580-3

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