Adrenal leiomyoma is an extremely rare and benign tumor, usually presents as an incidental finding. Generally, this tumor
is a non-functional large adrenal mass. The majority of leiomyomas of the adrenal gland are called as “incidentalomas”
because they are found in absence of clinical symptoms and represents an unexpected finding during an abdominal ultrasound
or computed tomography (CT) scan. Here we describe a 40-year-old man seropositive for the human immunodeficiency
virus (HIV), under highly active antiretroviral therapy who presents a heterogeneously left adrenal mass in the
context of a routine ultrasound abdominal scan. A CT abdominal scan confirms this finding. Laboratory results revealed
that the tumor was non-functional. Because the possibility of adrenal carcinoma, the patient underwent a successful left
adrenalectomy. Histopathology examination and immunohistochemistry techniques confirm the diagnosis of leiomyoma.
Adrenal leiomyoma should be included in the differential diagnosis of unilateral, non-functional adrenal tumors in HIV
patients.
Incidental adrenal tumors are often diagnosed during abdominal
ultrasonography or computerized tomography (CT) studies
for other pathologies. In human immunodeficiency virus (HIV)
infected patients, leiomyomas are described with more frequency
than in the general population. Also, in AIDS patients,
these tumors have been well described in association with
Epstein-Barr virus (EBV) A 40-year-old HIV seropositive man with diagnosis of AIDS infection. HIV-seropositive male with an inci
dental adrenal mass that was diagnosed as a leiomyoma on
histopathological and immunohistochemical (IHQ) studies. A
literature review on adrenal leiomyoma was also made, including
Pub Med, Medline and Embase for articles published
until December 2015. pheochromocytoma. The patient underwent a left adrenalectomy
because of the size of the lesion and the radiological appearance;
macroscopic pathological examination of the surgical
piece showed a well-circumscribed and encapsulated large
mass; histopathological analysis revealed the smooth muscle
origin of the tumor.
Histologic feature includes a mesenchymal tumor characterized
by the fusocellular proliferation of spindle cells with cigarshaped
nuclei, eosinophilic cytoplasm with areas of hyalinosis,
compatible with the diagnosis of smooth muscle tumor.
Functional tests including a serum cortisol level at 08:00 h and at late-night were normal and ruled out the presence of a cortisol-producing adenoma. The patient was normotensive repeatedly during admission to exclude an asymptomaticDiagnosis was confirmed by a positive immunostaining for smooth muscle actin. The tumor cells showed strongly immunoreactive for specific antismooth muscle actin and partial desmin expressionLeiomyomas of the adrenal glands are very rare tumors except in AIDS population. They are benign tumors composed of smooth muscle cells. An adrenal incidentaloma is defined as a clinically unapparent adrenal tumor, generally of 1 cm or more, that is discovered during radiological studies performed for other causes. Adrenal incidentalomas are diagnosed in approximately 1% of abdominal CT scans. Also, in autopsy studies, asymptomatic adrenal masses are discovered in up to 9% of patients. Diagnosis criteria for adrenal incidentaloma have been well established and include test to determine the functional tumor status and the histopathology. Adrenal leiomyomas have a wide range of age at presentation, with a median of 38 years and female predominance (66, 6%). These tumors are typically an adrenal unilateral solitary mass lesion with a median size of 5 cm.
Functional tests including a serum cortisol level at 08:00 h and at late-night were normal and ruled out the presence of a cortisol-producing adenoma. The patient was normotensive repeatedly during admission to exclude an asymptomaticDiagnosis was confirmed by a positive immunostaining for smooth muscle actin. The tumor cells showed strongly immunoreactive for specific antismooth muscle actin and partial desmin expressionLeiomyomas of the adrenal glands are very rare tumors except in AIDS population. They are benign tumors composed of smooth muscle cells. An adrenal incidentaloma is defined as a clinically unapparent adrenal tumor, generally of 1 cm or more, that is discovered during radiological studies performed for other causes. Adrenal incidentalomas are diagnosed in approximately 1% of abdominal CT scans. Also, in autopsy studies, asymptomatic adrenal masses are discovered in up to 9% of patients. Diagnosis criteria for adrenal incidentaloma have been well established and include test to determine the functional tumor status and the histopathology. Adrenal leiomyomas have a wide range of age at presentation, with a median of 38 years and female predominance (66, 6%). These tumors are typically an adrenal unilateral solitary mass lesion with a median size of 5 cm.
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