title: Primary adrenal leiomyosarcoma: a case report with immunohistochemical study and review of literature.
abstract: Primary adrenal mesenchymal tumors are exceptionally rare. Diagnosis is based entirely on histological and immunohistochemical evaluation which is indispensable not only for determining tumor type but also for predicting biological behavior. We report a rare case of primary leiomyosarcoma of the left adrenal gland, in a 60 year old woman who presented with flank pain. Computed tomography revealed a well defined left adrenal tumor which was surgically resected. Histological examination of the tumor showed malignant spindle cells in interlacing fascicles and whorls. Nuclear pleomorphism, tumor giant cells and abnormal mitotic figures were seen. On immunohistochemistry, the tumor cells showed reactivity for smooth muscle actin, vimentin and desmin; and were negative for cytokeratin, S100 protein, CD117 and HMB-45. A diagnosis of primary adrenal leiomyosarcoma was offered. Postoperative recovery of the patient was uneventful and the patient was symptom free with no evidence of tumor metastasis or recurrence 21 months after surgery.
authors.affiliation: Department of Pathology, Smt Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra, India.
authors.forename: Sanjay D
authors.initials: SD
authors.lastname: Deshmukh
authors.forename: Shridhar V
authors.initials: SV
authors.lastname: Babanagare
authors.forename: Mani
authors.initials: M
authors.lastname: Anand
authors.forename: Dilip P
authors.initials: DP
authors.lastname: Pande
authors.forename: Prasanna
authors.initials: P
authors.lastname: Yavalkar
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000601:surgery; D000311:Adrenal Glands / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed