Advertisement

Clinical and Translational Oncology

, Volume 19, Issue 5, pp 641–649 | Cite as

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

  • Y. Zhang
  • P. Cai
  • M. Chen
  • X. YiEmail author
  • L. Li
  • D. Xiao
  • W. Liu
  • W. Li
  • Y. Li
Research Article

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.

Keywords

Primitive neuroectodermal tumors (PNETs) Computed tomography (CT) Magnetic resonance imaging (MRI) Adrenal tumors Diagnosis 

Notes

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).

Compliance with ethical standards

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.

References

  1. 1.
    Biegel JA, Rorke LB, Packer RJ, Sutton LN, Schut L, Bonner K, et al. Isochromosome 17q in primitive neuroectodermal tumors of the central nervous system. Genes Chromosomes Cancer. 1989;1:139–47.CrossRefPubMedGoogle Scholar
  2. 2.
    Dehner LP. Peripheral and central primitive neuroectodermal tumors. A nosologic concept seeking a consensus. Arch Pathol Lab Med. 1986;110:997–1005.PubMedGoogle Scholar
  3. 3.
    Kushner BH, Hajdu SI, Gulati SC, Erlandson RA, Exelby PR, Lieberman PH. Extracranial primitive neuroectodermal tumors. The Memorial Sloan-Kettering Cancer Center experience. Cancer. 1991;67:1825–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Hari S, Jain TP, Thulkar S, Bakhshi S. Imaging features of peripheral primitive neuroectodermal tumours. Br J Radiol. 2008;81:975–83.CrossRefPubMedGoogle Scholar
  5. 5.
    Jürgens H, Bier V, Harms D, Beck J, Brandeis W, Etspüler G, et al. Malignant peripheral neuroectodermal tumors. A retrospective analysis of 42 patients. Cancer. 1988;61:349–57.CrossRefPubMedGoogle Scholar
  6. 6.
    Duan XH, Ban XH, Liu B, Zhong XM, Guo RM, Zhang F, et al. Intraspinal primitive neuroectodermal tumor: imaging findings in six cases. Eur J Radiol. 2011;80:426–31.CrossRefPubMedGoogle Scholar
  7. 7.
    Mandal PK, Mukherjee S, Roy S, Bhattacharyya NK. PNET of kidney: report of four cases. Indian J Med Paediatr Oncol. 2012;33:130–3.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Karpate A, Menon S, Basak R, Yuvaraja TB, Tongaonkar HB, Desai SB. Ewing sarcoma/primitive neuroectodermal tumor of the kidney: clinicopathologic analysis of 34 cases. Ann Diagn Pathol. 2012;16:267–74.CrossRefPubMedGoogle Scholar
  9. 9.
    Dutta D, Shivaprasad KS, Das RN, Ghosh S, Chowdhury S. Primitive neuroectodermal tumor of adrenal: clinical presentation and outcomes. J Cancer Res Ther. 2013;9:709–11.CrossRefPubMedGoogle Scholar
  10. 10.
    Yoon JH, Kim H, Lee JW, Kang HJ, Park HJ, Park KD, et al. Ahn, Ewing sarcoma/peripheral primitive neuroectodermal tumor in the adrenal gland of an adolescent: a case report and review of the literature. J Pediatr Hematol Oncol. 2014;36:e456–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Sasaki T, Onishi T, Yabana T, Hoshina A. Ewing’s sarcoma/primitive neuroectodermal tumor arising from the adrenal gland: a case report and literature review. Tumori. 2013;99:e104–6.PubMedGoogle Scholar
  12. 12.
    Abi-Raad R, Manetti GJ, Colberg JW, Hornick JL, Shah JG, Prasad ML. Ewing sarcoma/primitive neuroectodermal tumor arising in the adrenal gland. Pathol Int. 2013;63:283–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Zhang L, Yao M, Hisaoka M, Sasano H, Gao H, Zhang Y, et al. Primary Ewing sarcoma/primitive neuroectodermal tumor in the adrenal gland. APMIS. 2016;. doi: 10.1111/apm.12544.Google Scholar
  14. 14.
    Teixeira U, Goldoni M, Unterleider M, Diedrich J, Balbinot D, Rodrigues P, Fontes F Waechter, et al. Primitive neuroectodermal tumor of the pancreas: a case report and review of the literature. Case Rep Surg. 2015;2015:276869.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Dunnick NR. Hanson lecture. Adrenal imaging: current status. AJR Am J Roentgenol. 1990;154:927–36.CrossRefPubMedGoogle Scholar
  16. 16.
    Taffel M, Haji-Momenian S, Nikolaidis P, Miller FH. Adrenal imaging: a comprehensive review. Radiol Clin N Am. 2012;50:219–43.CrossRefPubMedGoogle Scholar
  17. 17.
    Qian X, Kai X, Shaodong L, Gaohong C, Hong M, Jingjing L. Radiological and clinicopathological features of pPNET. Eur J Radiol. 2013;82:e888–93.CrossRefPubMedGoogle Scholar
  18. 18.
    Li X, Zhang W, Song T, Sun C, Shen Y. Primitive neuroectodermal tumor arising in the abdominopelvic region: CT features and pathology characteristics. Abdom Imaging. 2011;36:590–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Dick EA, Mchugh K, Kimber C, Michalski A. Imaging of non-central nervous system primitive neuroectodermal tumours: diagnostic features and correlation with outcome. Clin Radiol. 2001;56:206–15.CrossRefPubMedGoogle Scholar
  20. 20.
    Gong J, Zhang Y, Zuo M, Yang Z, Zang D, Bao S, et al. Imaging findings of abdominal peripheral primitive neuroectodermal tumor: report of four cases with pathological correlation. Clin Imaging. 2009;33:196–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Ba L, Tan H, Xiao H, Guan Y, Gao J, Gao X. Radiologic and clinicopathologic findings of peripheral primitive neuroectodermal tumors. Acta Radiol. 2015;56:820–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Seo JM, Park BK, Park SY, Kim CK. Characterization of lipid-poor adrenal adenoma: chemical-shift MRI and washout CT. Am J Roentgenol. 2014;202:1043–50.CrossRefGoogle Scholar
  23. 23.
    Zhang YM, Lei PF, Chen MN, Lv XF, Ling YH, Cai PQ, et al. CT findings of adrenal schwannoma. Clin Radiol. 2016;71:464–70.CrossRefPubMedGoogle Scholar
  24. 24.
    Mannelli M, Colagrande S, Valeri A, Parenti G. Incidental and metastatic adrenal masses. Semin Oncol. 2010;37:649–61.CrossRefPubMedGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2016

Authors and Affiliations

  • Y. Zhang
    • 1
  • P. Cai
    • 2
  • M. Chen
    • 3
  • X. Yi
    • 1
    Email author
  • L. Li
    • 2
  • D. Xiao
    • 4
  • W. Liu
    • 1
  • W. Li
    • 1
  • Y. Li
    • 5
  1. 1.Department of Radiology, Xiangya HospitalCentral South UniversityChangshaPeople’s Republic of China
  2. 2.Imaging Diagnosis and Interventional CenterSun Yat-sen University Cancer CenterGuangzhouPeople’s Republic of China
  3. 3.Department of Ultrasonography, Xiangya HospitalCentral South UniversityHunanPeople’s Republic of China
  4. 4.Department of Pathology, Xiangya HospitalCentral South UniversityHunanPeople’s Republic of China
  5. 5.Departments of General Surgery, Xiangya HospitalCentral South UniversityHunanPeople’s Republic of China

Personalised recommendations