title: Rare adrenal gland incidentaloma: an unusual Ewing's sarcoma family of tumor presentation and literature review.
abstract: BACKGROUND
  Members of the Ewing's sarcoma family of tumor (ESFT) are malignant neoplasms and rarely observed in the adrenal gland.
  
  
  METHODS
  We report an extremely exceptional case of ESFT rising from the adrenal gland in a 57-year-old Chinese man. The patient was hospitalized with abdominal swelling for 2 months. Computed tomography (CT) scan revealed a nearly-circular mass measuring about 8.1 × 10.6 cm in the right adrenal region. The patient underwent right adrenal resection. Histopathologic examination found the tumor was composed of small round blue cells forming typical Homer-Wright rosettes in focal area. The immunohistochemical analysis confirmed the case to be ESFT, which was positive for membranous CD99 and nuclear FLI-1. The patient was scheduled for four courses of large doses of chemotherapy and died for cancer metastasis one year later after surgery.
  
  
  CONCLUSIONS
  Histopathological evidence of Homer-Wright rosettes and immunohistochemical markers positivity, such as CD99 and FLI-1, are valuable factors for ESFT diagnosis, although cytogenetic analysis is considered as the gold standard. Complete surgery is the treatment of choice for ESFT and adjuvant radiotherapy and combination chemotherapy can significantly improve the survival rate of postoperative patients.
authors.affiliation: Department of Urology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Urology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453100, China.
authors.forename: Shuaiqi
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Urology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
authors.forename: Shukun
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Urology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
authors.forename: Kaixuan
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Urology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
authors.forename: Erpeng
authors.initials: E
authors.lastname: Liu
authors.affiliation: Department of Urology, First Hospital of Jilin University, Changchun, Jilin, 130021, China.
authors.forename: Faping
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Urology, First Hospital of Jilin University, Changchun, Jilin, 130021, China. hou63@163.com.
authors.forename: Yuchuan
authors.initials: Y
authors.lastname: Hou
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D018242:Neuroectodermal Tumors, Primitive / Q000473:pathology; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
keywords: Adrenal gland; Diagnosis, Treatment; Ewing’s sarcoma family of tumor