title: A Case Report of Bilateral Sarcomatoid Carcinoma of Adrenal Glands With Adrenal Insufficiency.
abstract: Adrenocortical carcinomas are relatively rare, but they are considered to be highly aggressive malignant tumors. Sarcomatoid carcinomas represent an even more aggressive type. Bilateral malignant adrenal tumors are extraordinary rare, except for those that represent metastatic spread from a primary neoplasm. Here we report a case of a 69-year-old woman who presented symptoms that raised strong suspicions of adrenal insufficiency. Bilateral adrenal masses, identified in the imaging study, were responsible for the clinical manifestation and surgically resected. Surgical specimens of the bilateral adrenal tumors shared histological features compatible with sarcomatoid carcinoma. It was very difficult to confirm that the sarcomatoid carcinomas were derived from the cortex of the adrenal glands, but careful morphological observation and the panel of antibodies used for immunohistochemistry made the diagnosis possible. This is the first report of sarcomatoid carcinomas involving both adrenal glands. It should be emphasized that sarcomatoid carcinoma can arise bilaterally from even functionally impaired adrenal glands.
authors.affiliation: Shimane University School of Medicine, Shimane, Japan kanatomo@med.shimane-u.ac.jp.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ishikawa
authors.affiliation: Shimane University School of Medicine, Shimane, Japan.
authors.forename: Mamiko
authors.initials: M
authors.lastname: Nagase
authors.affiliation: Shimane University Hospital, Shimane, Japan.
authors.forename: Saki
authors.initials: S
authors.lastname: Takami
authors.affiliation: Shimane University School of Medicine, Shimane, Japan.
authors.forename: Asuka
authors.initials: A
authors.lastname: Araki
authors.affiliation: Shimane University School of Medicine, Shimane, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ishikawa
authors.affiliation: Shimane University School of Medicine, Shimane, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Koike
authors.affiliation: Shimane University School of Medicine, Shimane, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiina
authors.affiliation: Shimane University School of Medicine, Shimane, Japan.|Shimane University Hospital, Shimane, Japan.
authors.forename: Riruke
authors.initials: R
authors.lastname: Maruyama
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D000309:Adrenal Insufficiency / Q000209:etiology*; D018268:Adrenocortical Carcinoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology*; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry
chemical_list: D014408:Biomarkers, Tumor
keywords: adrenal insufficiency; adrenocortical carcinoma; bilateral adrenal tumor; sarcomatoid