Right adrenal sarcoma

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Right flank pain; known and treated case of ovarian cancer.

Patient Data

Age: 60 years
Gender: Female
CT

The hepatic attenuation value is less than of the spleen, suggesting fatty liver disease. 

An 85 × 65 mm heteroenhancing mass is present at anatomical location of right adrenal gland. Its mean attenuation value on PV phase and delayed images measured 30 HU and 43 HU, respectively.

A 10 mm midline fascial defect is present at anterior abdominal wall that some omental fat herniated through it.

The uterus and ovaries are not seen at anatomical location due to prior resection. There is no sign of local tumoral recurrence at surgical site. No regional lymphadenopathy is identified.

Degenerative changes as osteophytosis are seen at the lumbar spine.

Pathology

Ultrasound guided core needle biopsy performed for the right adrenal mass and histopathology evaluation shows spindle cell sarcoma and total resection recommended. The patient underwent surgical resection and the final histopathology report confirms undifferentiated pleomorphic sarcoma.

Case Discussion

In a known and operated case of ovarian cancer, recently detected large right adrenal mass resected and histopathology evaluation with IHC confirms undifferentiated pleomorphic sarcoma.

Undifferentiated pleomorphic sarcomas are an uncommon tumor overall but are considered as one of the most common types of primary retroperitoneal neoplasms

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