Adrenal leiomyosarcoma: A case report

I. Smichi, Blel R. Aloui, A. Arfaoui, N. Znaidi, A. Derouiche, F. Fereh, YSH. Zidi, L. BelHadjKacem, S. Aloui, S. Rammeh, M. Chebil, R. Zermani, N. Kourda

Abstract


Primary adrenal mesenshymal tumors are rare.diagnosis are based on histological and immunohistochemical evaluation. Through this case we proposed to detail the clinical and pathological features of this rare entity.
We report a case of a 52 year old man with history of left upper quadrant abdominal mass.
We received a mass of 10cm bumpy drive, adjoining the surrénale.it was multinodular solid whitish appearance with hemorrhagic alterations.
Histological examination revealed that the mass corresponded to a tumor proliferation vaguely nodular, made by spindle cells the cytoplasm was abundant eosinophilic.The nuclei were elongated, irregular, pleomorphic and sometimes monstrous.The mitosis were many 8M/10 LF.Thestroma was myxoid.on places we noted the presence of foci of tumor necrosis (<50% of tumor mass). The tumor infiltrated the residual adrenal gland.
Immunohistochemical study showed that the tumor cells expressed intensely desmin and smooth muscle actin.Themarquage was negative with PS100, CD117 and MDM2.
The diagnosis of leiomyosarcoma of adrenal gland was made.
The diagnosis of leiomyosarcoma of adrenal gland is one of exclusion and is based on morphological and immunohistochemical evaluation. Low grade features, absence of lymphovascular invasion and necrosis, favor long term survival after aggressive surgical resection.

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