Pol. Merkur. Lek (Pol. Med. J.), 2018, XLV/269: 189-191 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2018, XLV/269: 189-191

Title: Leiomyosarcoma of the adrenal gland – two cases report 

Authors: Samsel R, Cichocki A, Roszkowska-Purska K, Falkowski S. 

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Leiomyosarcoma of the adrenal gland – two cases report

Samsel R1, Cichocki A1, Roszkowska-Purska K2, Falkowski S3.

Maria Skłodowska-Curie Institute – Oncology Center of Warsaw, Poland: 1Department Of Surgery Clinic of Oncological Surgery and Neuroendocrine Tumors, 2Department of Pathology, 3Department of Soft Tissue/Bone Sarcoma and Melanoma

Primary adrenal leiomyosarcomas are very rare adrenal mesenchymal tumours, only few dozen has been reported in the English language literature so far. We present two cases of patients with primary adrenal leiomyoosarcomas. 80 year-old female admitted with left adrenal tumour with presumptive diagnosis of nonadenoma, laparoscopic adrenalectomy was performed and 85 year-old man who underwent surgical resection by laparotomy of adrenal tumour suspected for adrenal carcinoma. Native density on unenhanced CT was 30 (HU) and 28 (HU) respectively and absolute and relative contrast washout was non-characteristic. Pathologic report reviled thinly encapsulated tumours composed of neoplastic cells with strong cytoplasmic reactivity for smooth muscle actin, desmin and vimentin. Male patient 20 months after surgery was diagnosed with multiple nonresectable metastases, systemic treatment was introduced. Female patient 28 months after surgery has no signs and symptoms of recurrence. We describe the clinical course and a brief review of clinical and histological features , biologic behaviour and diagnostic and therapeutic strategies. The extremely rare occurrence of primary adrenal leiomyosarcoma and a scientific literature based on single cases present challenges in establishing any firm conclusions on management and prognosis. Obviously it’s impossible to have proper diagnosis based on clinical symptoms and diagnostic imaging. Radical surgery with free margins seems to be treatment of choice.

Key words: leiomyosarcoma, adrenalectomy, adrenal leiomyosarcoma, adrenal incidentaloma. rare adrenal tumor

Pol Med J, 2018; XLV (269); 189–191