Presentation
Abdominal discomfort.
From the case:
Adrenal angiosarcoma
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Massive right adrenal mass with scattered small foci of calcification and enhancement. Retroperitoneal fluid or soft tissue extends inferiorly and contacts the right upper renal pole. Displacement/compression of the right hepatic lobe with invasion into the IVC.
Case Discussion
Surgical pathology: "High grade epitheliod angiosarcoma, with extensive necrosis. Malignant cells are positive for cytokerative AE1/AE3 and negative for EMA, melanoma cocktail, inhibit, synaptophysin, and chromogranin by immunolabeling."
Very rare tumor appropriately favored to be adrenal cortical carcinoma. Only about 22 cases have been reported1.