title: Is adrenal ovarian thecal metaplasia a misnomer? Report of three cases of radial scar-like spindle cell myofibroblastic nodule of the adrenal gland.
abstract: Ovarian thecal metaplasia is a rare tumor-like mesenchymal lesion of the adrenal gland that has been reported mainly in postmenopausal women and rarely in men. It was originally described as a wedge-shaped lesion composed of ovarian-like stroma resembling theca that shows continuity with the capsule of the adrenal gland. We report three cases and identify that these lesions can resemble a radial scar. While a single case has been reported to contain true ovarian stromal elements, there was no evidence of steroidogenic differentiation in our cases. These findings justify the need for a better terminology since the entity falls within the spectrum of fibroblastic-myofibroblastic proliferations. We propose the terminology of "radial scar-like spindle cell myofibroblastic nodule of the adrenal gland" as a more accurate nomenclature to designate these lesions. Although rare, calcifying fibrous tumor of the adrenal gland, hypertrophic nerve bundles, and peripheral nerve sheath tumors may mimic these lesions.
authors.affiliation: Department of Pathology, University Health Network, University of Toronto, 200 Elizabeth Street, 11th floor, Toronto, ON, Canada. Ozgur.Mete2@uhn.on.ca
authors.forename: Ozgur
authors.initials: O
authors.lastname: Mete
authors.forename: Simon
authors.initials: S
authors.lastname: Raphael
authors.forename: Amrah
authors.initials: A
authors.lastname: Pirzada
authors.forename: Sylvia L
authors.initials: SL
authors.lastname: Asa
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000473:pathology* / Q000601:surgery; D000368:Aged; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D058628:Myofibroblasts / Q000473:pathology*; D009626:Terminology as Topic