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1.
Indian J Surg Oncol ; 15(Suppl 3): 395-399, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39328720

RESUMO

Schwannomas, which are benign mesenchymal tumors derived from Schwann cells, are common in the central nervous system. While they are commonly seen in the extremities and head-neck area, their presence in visceral organs, particularly the adrenals, is uncommon. Adrenal schwannomas are frequently discovered incidentally, offering a diagnostic difficulty because of their uncommon presentation. A 46-year-old woman initially sought treatment for symptoms related to uterine fibroids and biliary stones. Diagnostic imaging uncovered an adrenal incidentaloma, necessitating a laparoscopic right adrenalectomy. The mass was determined to be an adrenal schwannoma based on its spindle-shaped cells and S-100 immunohistochemistry positivity. The patient's symptoms improved, and she was discharged with stable vital signs. Preoperative diagnosis of adrenal schwannomas is difficult and requires histological confirmation. When diagnosing non-secreting adrenal tumors with unusual radiology, surgeons should investigate for schwannoma. Post-resection adrenal schwannoma follow-up studies are scarce; however, they imply a low risk of recurrence or metastasis.

2.
Cureus ; 16(8): e66239, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39238722

RESUMO

Schwannomas, originating from the Schwann sheath of peripheral or cranial nerves, are rare tumors commonly found in the head and neck or extremities. Adrenal schwannomas, however, are exceedingly rare, accounting for less than 1% of all adrenal tumors. Here, we present a case of a 31-year-old Caucasian woman diagnosed with an adrenal schwannoma, which was incidentally discovered during imaging studies for an unrelated issue. Following laparoscopic adrenalectomy, the patient developed chylous ascites (CA) and coexistent chylothorax, posing a diagnostic challenge and necessitating a multidisciplinary approach to management.

3.
Radiol Case Rep ; 19(8): 3008-3012, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38741689

RESUMO

Adrenal schwannoma is a rare tumor of Schwann cell origin that represents less than 0.2% of all adrenal tumors. These typically benign tumors are most often found in the head, neck, and limbs. However, schwannomas can also rarely occur rarely in the adrenal gland within the retroperitoneal cavity. In the adrenal gland, these tumors arise from the medulla and are difficult to diagnose, often misdiagnosed as other benign or malignant entities. In this article, we report the case of a 43-year-old female with a large left adrenal mass revealed by biopsy to be a schwannoma. We focus on the use of radiological imaging modalities and immunohistochemical analysis to optimize diagnosis and treatment intervention of this rare tumor.

4.
Cureus ; 16(2): e53619, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38449972

RESUMO

Adrenal schwannomas are exceptionally rare tumors affecting about 0.2%, originating from the adrenal gland, presenting diagnostic challenges due to their nonspecific clinical features and overlapping radiological characteristics with other adrenal masses. Here, we report the case of a 49-year-old female with no significant medical history presenting with diffuse abdominal pain. Imaging studies, including contrast-enhanced computerized tomography (CECT), revealed a well-defined mass within the right adrenal gland. Given inconclusive radiological findings and persistent symptoms, surgical exploration was performed, leading to the identification and resection of the mass. Microscopic examination, including immunohistochemistry, confirmed the schwannomatous origin of the tumor. The final diagnosis of an adrenal schwannoma was established after a histopathological examination. Postoperatively, the patient was treated with antibiotics and discharged on oral antibiotics after suture removal on advised follow-up after 15 days. This case highlights the diagnostic complexities associated with adrenal schwannomas and emphasizes the necessity of surgical intervention for conclusive diagnosis. The report aims to contribute to the limited literature on adrenal schwannomas, enhancing our understanding of their clinical presentation and reinforcing the importance of a multidisciplinary approach in their diagnosis and management.

5.
Diagn Pathol ; 18(1): 112, 2023 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-37833805

RESUMO

Schwannomas are benign, generally indolent tumors of neural crest origin and comprise the most common histologic tumor of peripheral nerves. Schwannomas are a rare histology for retroperitoneal tumors and very rare histologic findings for tumors of the adrenal gland with fewer than 50 cases in the reported literature. Here we present a case report of a non-hormonally functional but metabolically active adrenal tumor with indeterminate imaging characteristics with final pathology showing a 6.1 cm adrenal schwannoma as well as historical institutional pathology review revealing two additional cases.


Assuntos
Neoplasias das Glândulas Suprarrenais , Neurilemoma , Neoplasias Retroperitoneais , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fluordesoxiglucose F18 , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia
6.
Front Surg ; 10: 1175633, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37292491

RESUMO

Adrenal schwannomas are rare benign tumors with no specific imaging and laboratory findings to diagnose preoperatively. Due to the limited number of cases in the literature, clinical, imaging, and pathological findings are presented in this study. Case 1 is a 61-year-old woman patient who has a 31-mm mass in the right adrenal gland. This mass was nonfunctional; in imaging studies, this mass had a cystic necrotic component, and high 18-fluorodeoxyglucose (FDG) uptake was seen. There was no metaiodobenzylguanidine (MIBG) uptake. Laparoscopic transabdominal right adrenalectomy was performed, and the pathology result was consistent with adrenal schwannomas. Case 2 is a 63-year-old man patient who presented with a 38-mm mass in the left adrenal gland. This mass was nonfunctional and similar to that in Case 1; this mass had a cystic component. Laparoscopic transabdominal left adrenalectomy was performed. The diagnosis of adrenal schwannoma with degeneration was revealed. Case 3 was a 72-year-old woman patient admitted to the hospital for a 125-mm left adrenal mass. Similar to Case 1, this mass also had a cystic necrotic component in imaging studies. High FDG uptake was seen, and the patient underwent conventional adrenalectomy due to the suspicion of malignancy. After pathological evaluation, a diagnosis of adrenal schwannoma was made. A main diagnostic challenge in adrenal schwannomas is the preoperative diagnosis. These masses have no pathognomonic finding or specific hormonal function. Imaging findings of these masses may increase the suspicion of malignancy, which may affect decisions for surgery and the surgical technique.

7.
Cureus ; 15(2): e34485, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36874342

RESUMO

Benign nerve sheath tumours such as schwannomas commonly involve the peripheral and cranial nerves. A schwannoma in the adrenal gland is a very rare occurrence, which arises from the adrenal medulla. Its most common presentation is a non-functional incidentaloma. It does not have any unique imaging characteristic distinguishing it from other adrenal masses; hence, its diagnosis is usually confirmed by final histopathology. In this report, we present two cases of an adrenal schwannoma for which we anticipated an unusual diagnosis, which was confirmed through adrenalectomy on histopathology.

8.
Cureus ; 15(1): e33710, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36793844

RESUMO

Schwannomas are tumors of neoplastic Schwann cells generally found in peripheral nerves in the head, neck, and extremities. They do not demonstrate hormonal abnormalities, and initial symptoms are typically secondary to adjacent organ compression. These tumors are rarely found in the retroperitoneum. We present a rare finding of an adrenal schwannoma in a 75-year-old female who presented to the emergency department with right flank pain. Imaging incidentally demonstrated a 4.8 cm left adrenal mass. Ultimately, she underwent a left robotic adrenalectomy, and immunohistochemical testing confirmed the presence of an adrenal schwannoma. It is imperative to undergo adrenalectomy and immunohistochemical testing to confirm the diagnosis and rule out malignancy.

9.
Cureus ; 14(3): e23296, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35464584

RESUMO

Adrenal schwannomas are extremely uncommon tumors. We report the case of a 39-year-old male with a right adrenal mass. Laboratory tests were normal and radiological exams revealed the adrenal tumor. Open surgical adrenalectomy was performed. The postoperative course was uneventful. Microscopy and immunohistochemistry revealed a cellular schwannoma. Adrenal schwannomas are rare tumors, very difficult to diagnose in preoperative evaluation. Surgical excision of the tumor, histological and immunohistochemical examination of the specimen provide a definitive diagnosis. Prognosis is generally very good. Recurrence rates are related to positive surgical margins.

10.
Int Med Case Rep J ; 14: 617-620, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34526828

RESUMO

Schwannoma of the adrenal gland is very rare, comprising 0.2% of adrenal tumors, presenting usually as non-specific abdominal pain. We report such a rare case in a 50-year-old female. Her only complaint was right lumbar pain. Ultrasonography (USG) and computed tomography (CT) both showed a supra renal cystic mass most likely of adrenal origin. Excision of mass was performed. Post-operative course was uneventful. Histopathology showed a benign tumor of Schwann cell origin. Usually, pre-operative imaging including CT and magnetic resonance imaging (MRI) are inconclusive and diagnosis has to be confirmed on histopathology.

11.
Endocr Connect ; 10(5): 543-549, 2021 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-33909596

RESUMO

BACKGROUND: Adrenal schwannomas (AS) are extremely rare neoplasms. This study shares our experience regarding the diagnosis and operative management of AS. METHODS: Clinical details, radiologic, laboratory, and pathologic findings as well as follow-up data were analysed retrospectively for 13 AS patients who accepted surgery at a tertiary referral hospital in China between 1 January 1996, and 31 December 2017. RESULTS: The mean age of the patients at diagnosis was 44.7 ± 13.7 years (range 19-62 years; male: female ratio, 1:1.16), of whom seven patients had unilateral AS on the right side, and the remaining six on the left side. None of the cases were hormonally active. None of the 13 cases were diagnosed as AS by CT imaging before the operation. Among the patients, ten were asymptomatic. The mean preoperative size was 7.1 ± 3.2 cm (range 1.6-12.6 cm). All patients underwent surgery, with open adrenalectomy in five patients and laparoscopy in eight patients. The mean tumor size on pathologic examination was 6.8 ± 3.0 cm (range 3.0-11.7 cm). The surgical specimens were confirmed by pathological examination. During a median follow-up of 60.8 ± 17.7 months, no patients showed recurrence or metastasis. CONCLUSION: The preoperative diagnosis of AS remains difficult despite the advances in imaging examinations. After complete resection, the prognosis of AS is excellent.

12.
Indian J Pathol Microbiol ; 64(2): 379-381, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33851640

RESUMO

WHO classification of adrenal tumors. Only a handful of cases have been reported so far. A 30-year-old lady presented with cerebrovascular accident. CT scans of the abdomen and pelvis revealed a 3.5-cm well-defined, smooth margined, heterogeneously enhancing, mass lesion in the right adrenal gland. She had no endocrine symptoms and urinary metanephnines were normal. She underwent right adrenalectomy for incidentaloma. Histopathology of the excised mass showed features of an adrenal schwannoma. Diagnosis of adrenal schwannoma on imaging studies is difficult preoperatively and raises suspicion of other adrenal tumors. Surgical excision followed by histopathology confirms the diagnosis.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/patologia , Neurilemoma/diagnóstico , Neurilemoma/patologia , Neoplasias das Glândulas Suprarrenais/patologia , Glândulas Suprarrenais/cirurgia , Adulto , Feminino , Humanos , Achados Incidentais , Neurilemoma/cirurgia , Acidente Vascular Cerebral/patologia , Tomografia Computadorizada por Raios X
13.
Urol Ann ; 7(2): 254-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25837378

RESUMO

Schwannomas are rare tumors in the retroperitoneal location. They can pose a diagnostic dilemma when presenting as an adrenal mass lesion due to their imaging characteristics. We report two cases of juxta-adrenal schwannomas presenting as symptomatic adrenal mass lesions. In both the cases, the clinical examination and functional evaluation was unremarkable and the radiological examination revealed a mixed intense adrenal mass lesion in one case with predominantly hyperintense areas and a very hyperintense lesion in another, in T2-weighted images, mimicking a adrenocortical malignancy and a pheochromocytoma respectively. Both cases were treated by surgical excision. Histopathological examination established the correct diagnosis of schwannoma, which was confirmed by immunohistochemical staining. Juxta-adrenal schwannoma is rare tumors of the retroperitoneum, which should also be borne in mind whenever encountering large nonsecreting adrenal tumors. We report a unique imaging characteristic, which helps in preoperative identification these rare lesions.

14.
Indian J Urol ; 23(4): 469-70, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19718306

RESUMO

Schwannoma is a rare primary tumor originating in the neural sheath with a good prognosis. The management is surgical. We present a case in which a retroperitoneal mass arising from the adrenal gland was excised and histopathology revealed a schwannoma with coexisting tuberculosis. This case report highlights the need to be aware of the potential coexistence of tuberculosis in any case of incidentaloma, especially due to resurgence of tuberculosis as a global epidemic with the increasing incidence of HIV and AIDS. To the best of our knowledge, this is the first reported case of a schwannoma and tuberculosis coexisting in the adrenal gland.

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