Imaging findings of adrenal primitive neuroectodermal tumors: a series of seven cases
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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.
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.
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.
KeywordsPrimitive neuroectodermal tumors (PNETs) Computed tomography (CT) Magnetic resonance imaging (MRI) Adrenal tumors Diagnosis
This study was supported by the Freedom Exploration Program of Central South University (No. 2011QNZT153) and Natural Science Foundation of Hunan Province (No. 14JJ6001).
Compliance with 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.