title: Primary adrenal leiomyosarcoma with lymph node metastasis: a case report.
abstract: BACKGROUND
  Leiomyosarcomas typically originate in smooth muscle cell. Leiomyosarcoma potentially arising from the adrenal gland is an extremely rare mesenchymal tumors associated with delayed diagnosis and poor prognosis.
  
  
  METHODS
  A 34-year-old man visited our department complaining of right hypochondriac pain. Computed tomography demonstrated a solid mass measuring 5.2 cm in diameter above the right kidney, corresponding to the right adrenal gland, and a lymph node mass, which appeared to have invaded the IVC wall. Right adrenalectomy and lymphadenectomy were performed. A microscopic examination revealed primary adrenal leiomyosarcoma with lymph node metastasis. No adjuvant therapy was performed, and the patient remains recurrence-free at 10 months postoperatively.
  
  
  CONCLUSIONS
  We experienced a very rare case of primary adrenal leiomyosarcoma. Aggressive surgical resection including vascular reconstruction may be associated with improved survival.
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Onishi
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan. yyanagi@m.ehime-u.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yanagihara
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Kikugawa
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Miura
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Terutaka
authors.initials: T
authors.lastname: Noda
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Kakuda
authors.affiliation: Division of Diagnostic Pathology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Riko
authors.initials: R
authors.lastname: Kitazawa
authors.affiliation: Department of Urology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Tanji
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D006801:Humans; D007890:Leiomyosarcoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male
keywords: Adrenalectomy; IVC reconstruction; Primary adrenal leiomyosarcoma