Abstract
Objectives: Benign adrenal schwannoma is an extremely uncommon cause of incidentaloma. This article describes our experience with the diagnosis and treatment of adrenal schwannoma in a Chinese population of 6 patients. To our knowledge, this is the largest series of this uncommon adrenal tumor treated in a single center. Methods: From May 1999 to May 2009, 6 patients with incidentally discovered adrenal schwannoma were operated on at a tertiary referral hospital in Eastern China. Clinical details, radiographic features, laboratory examinations, pathological findings, and follow-up data of these patients were analyzed. Results: Of the 6 patients, 4 were females (F) and 2 were males (M), with a mean age of 40.5 yr (range: 30–47, M:F=2:1). The 6 patients were managed with open unilateral adrenalectomy; 5 patients had schwannomas on the left side, and 1 on right side. Abnormal urine catecholamine was detected in 1 patient. The mean pathological size of these tumors was 4.3±1.1 cm. The diagnosis of schwannoma was based on classic histological findings, and supported by immunohistochemistry of S-100, vimentin, and ABC positivity. In the follow-up of 47.5±32.3 months, no recurrence and metastasis were observed. Conclusions: Although there may be some clues for radiological diagnosis of adrenal schwannoma, preoperative misdiagnosis is not infrequent. Those tumors may occasionally have endocrine function. Histological examination is the key of diagnosis, and surgical resection is the treatment of choice once malignancy cannot be excluded by preoperative analyses.
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Jakowski JD, Wakely PE Jr, Jimenez RE. An uncommon type of adrenal incidentaloma: a case report of a schwannoma of the adrenal medulla with cytological, histological, and ultrastructural correlation. Annals Diagn Pathol 2008, 12: 356–61.
Lau SK, Spagnolo DV, Weiss LM. Schwannoma of adrenal gland: report of two cases. Am J Surg Pathol 2006, 30: 630–4.
Inokuchi T, Takiuchi H, Moriwaki Y, et al. Retroperitoneal ancient schwannoma presenting as an adrenal incidentaloma: CT and MR findings. Magn Reson Imaging 2006, 24: 1389–93.
Bedard YC, Horvath E, Kovacs K. Adrenal schwannoma with apparent uptake of immunoglobulins. Ultrasturct Pathol 1986, 10: 505–13.
Pittasch D, Klose S, Schmitt J, et al. Retroperitoneal schwannoma presenting as an adrenal tumor. Exp Clin Endocrinol Diabetes 2000, 108: 318–21.
Igawa T, Hakariya H, Tomonaga M. Primary adrenal schwannoma. Nippon Hinyokika Gakkai Zasshi 1998, 89: 567–70.
Suzuki K, Nakanishi A, Kurosaki Y, Nogaki J, Takaba E. Adrenal schwannoma: CT and MRI findings. Radiat Med 2007, 25: 299–302.
Onoda N, Ishikawa T, Toyokawa T, Takashima T, Wakasa K, Hirakawa K. Adrenal schwannoma treated with laparoscopic surgery. JSLS 2008, 12: 420–5.
Maweja S, Materne R, Detrembleur N, et al. Adrenal ganglioneuroma. A neoplasia to exclude in patients with adrenal incidentaloma. Acta Chir Belg 2007, 107: 670–4.
Takatera H, Takiuchi H, Namiki M, Takaha M, Ohnishi S, Sonoda T. Retroperitoneal schwannoma. Urology 1986, 28: 529–31.
Ridho FE, Adam FM, Adam JM. Adrenal incidentaloma. Acta Med Indones 2009, 41: 87–93.
Ilias I, Sahdev A, Reznek RH, Grossman AB, Pacak K. The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer 2007, 14: 587–99.
Chen-Pan C, Pan IJ, Yamamoto Y, Chen HH, Hayashi Y. Recovery of injured adrenal medulla by differentiation of pre-existing undifferentiated chromaffin cells. Toxicol Pathol 2002, 30: 165–72.
Goto J, Otsuka F, Omori M, Makino H. Adrenal ganglioneuroma accompanying catecholamine-producing adrenocortical cells. J Endocrinol Invest 2009, 32: 192.
Diab DL, Faiman C, Siperstein AE, Zhou M, Zimmerman RS. Virilizing adrenal ganglioneuroma in a woman with subclinical Cushing syndrome. Endocr Pract 2008, 14: 584–7.
Rha SE, Byun JY, Jung SE, Chun HJ, Lee HG, Lee JM. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 2003, 23: 29–43.
Huber K, Kalcheim C, Unsicker K. The development of the chromaffin cell lineage from the neural crest. Auton Neurosci 2009, 151: 10–6.
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Xiao, C., Xu, B., Ye, H. et al. Experience with adrenal schwannoma in a Chinese population of six patients. J Endocrinol Invest 34, 417–421 (2011). https://doi.org/10.1007/BF03346705
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DOI: https://doi.org/10.1007/BF03346705