Adrenal angiosarcoma

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Abdominal discomfort.

ct

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

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