title: Leiomyoma of the adrenal gland presenting as a non-functioning adrenal incidentaloma: case report and review of the literature.
abstract: A 31-year-old woman was incidentally found to have a large right adrenal mass by computed tomography imaging and underwent a workup that included endocrinological evaluation and positron emission tomography imaging. Laboratory results revealed the mass to be non-functioning. Imaging studies revealed a 9-cm heterogeneous mass that was not FDG avid. Because of concern for adrenal cortical carcinoma, the patient underwent a successful right adrenalectomy. Pathology examination demonstrated an 11-cm circumscribed mass consisting of uniform spindle cells without nuclear pleomorphism, necrosis, or mitotic activity. The diagnosis of leiomyoma was supported by a panel of immunohistochemical stains. Adrenal leiomyomas have been reported in the literature, although most are small and not preoperatively suspicious for malignancy. This case illustrates that benign tumors such as leiomyomas, when large and heterogeneous on imaging, can clinically mimic adrenal cortical carcinomas and should be included in the differential diagnosis of adrenal incidentalomas.
authors.affiliation: Department of Pathology, University of Michigan Health System, 1150 West Medical Center Drive, MSRB-2, C570D, Ann Arbor, MI 48109-0669, USA.
authors.forename: Jingmei
authors.initials: J
authors.lastname: Lin
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Wasco
authors.forename: Melvin
authors.initials: M
authors.lastname: Korobkin
authors.forename: Gerard
authors.initials: G
authors.lastname: Doherty
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Giordano
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology* / Q000601:surgery; D018268:Adrenocortical Carcinoma / Q000473:pathology; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D033162:Incidental Findings; D007889:Leiomyoma / Q000473:pathology* / Q000601:surgery; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed