Unusual case of primary adrenal squamous cell carcinoma
EAES Academy. Wu D. 07/05/22; 363148; P193
Ms. Diana Wu
Contributions
Contributions
Abstract
Aims:
The adrenal gland is commonly a secondary metastatic site of squamous cell carcinoma (SCC), however primary adrenal SCC has only been reported once previously in the literature. Here we present an unusual case of primary adrenal SCC.
Methods:
A 72 year old woman presented with significant left sided flank pain and weight loss. Imaging revealed a heterogenous left adrenal nodule 4.2cm in diameter with areas of necrosis. Plasma metanephrines, urinary steroid profile, urinary free cortisol, androgen profile and aldosterone renin ratio were all normal. FDG PET scan did not show any other obvious primary lesion. The patient had no other past medical history except for being an ex-smoker of 20 cigarettes per day from the age of 20 to 60. She was independent and lived at home with her husband.
Results:
The patient underwent laparotomy and intraoperatively the adrenal mass was found to have infiltrated the left kidney, tail of pancreas and spleen. Therefore, left adrenalectomy, left nephrectomy, distal pancreatectomy and para-aortic lymph node dissection were performed en-bloc (Figure 1). Her post-operative recovery was delayed by an intra-abdominal collection which was treated conservatively with antibiotics. Histopathology results showed SCC which was completed excised, with one of thirty lymph nodes involved. Since the occurrence of primary SCC of the adrenal gland is extremely rare, the patient was followed up with further CT chest, abdomen, and pelvis 3 months post-operatively, however no other lesion was found.
Conclusion:
This case demonstrated an unusual case of SCC in the adrenal gland with no obvious other primary lesion at the time of presentation. To our knowledge this is the second case of this kind to be reported.
The adrenal gland is commonly a secondary metastatic site of squamous cell carcinoma (SCC), however primary adrenal SCC has only been reported once previously in the literature. Here we present an unusual case of primary adrenal SCC.
Methods:
A 72 year old woman presented with significant left sided flank pain and weight loss. Imaging revealed a heterogenous left adrenal nodule 4.2cm in diameter with areas of necrosis. Plasma metanephrines, urinary steroid profile, urinary free cortisol, androgen profile and aldosterone renin ratio were all normal. FDG PET scan did not show any other obvious primary lesion. The patient had no other past medical history except for being an ex-smoker of 20 cigarettes per day from the age of 20 to 60. She was independent and lived at home with her husband.
Results:
The patient underwent laparotomy and intraoperatively the adrenal mass was found to have infiltrated the left kidney, tail of pancreas and spleen. Therefore, left adrenalectomy, left nephrectomy, distal pancreatectomy and para-aortic lymph node dissection were performed en-bloc (Figure 1). Her post-operative recovery was delayed by an intra-abdominal collection which was treated conservatively with antibiotics. Histopathology results showed SCC which was completed excised, with one of thirty lymph nodes involved. Since the occurrence of primary SCC of the adrenal gland is extremely rare, the patient was followed up with further CT chest, abdomen, and pelvis 3 months post-operatively, however no other lesion was found.
Conclusion:
This case demonstrated an unusual case of SCC in the adrenal gland with no obvious other primary lesion at the time of presentation. To our knowledge this is the second case of this kind to be reported.
Aims:
The adrenal gland is commonly a secondary metastatic site of squamous cell carcinoma (SCC), however primary adrenal SCC has only been reported once previously in the literature. Here we present an unusual case of primary adrenal SCC.
Methods:
A 72 year old woman presented with significant left sided flank pain and weight loss. Imaging revealed a heterogenous left adrenal nodule 4.2cm in diameter with areas of necrosis. Plasma metanephrines, urinary steroid profile, urinary free cortisol, androgen profile and aldosterone renin ratio were all normal. FDG PET scan did not show any other obvious primary lesion. The patient had no other past medical history except for being an ex-smoker of 20 cigarettes per day from the age of 20 to 60. She was independent and lived at home with her husband.
Results:
The patient underwent laparotomy and intraoperatively the adrenal mass was found to have infiltrated the left kidney, tail of pancreas and spleen. Therefore, left adrenalectomy, left nephrectomy, distal pancreatectomy and para-aortic lymph node dissection were performed en-bloc (Figure 1). Her post-operative recovery was delayed by an intra-abdominal collection which was treated conservatively with antibiotics. Histopathology results showed SCC which was completed excised, with one of thirty lymph nodes involved. Since the occurrence of primary SCC of the adrenal gland is extremely rare, the patient was followed up with further CT chest, abdomen, and pelvis 3 months post-operatively, however no other lesion was found.
Conclusion:
This case demonstrated an unusual case of SCC in the adrenal gland with no obvious other primary lesion at the time of presentation. To our knowledge this is the second case of this kind to be reported.
The adrenal gland is commonly a secondary metastatic site of squamous cell carcinoma (SCC), however primary adrenal SCC has only been reported once previously in the literature. Here we present an unusual case of primary adrenal SCC.
Methods:
A 72 year old woman presented with significant left sided flank pain and weight loss. Imaging revealed a heterogenous left adrenal nodule 4.2cm in diameter with areas of necrosis. Plasma metanephrines, urinary steroid profile, urinary free cortisol, androgen profile and aldosterone renin ratio were all normal. FDG PET scan did not show any other obvious primary lesion. The patient had no other past medical history except for being an ex-smoker of 20 cigarettes per day from the age of 20 to 60. She was independent and lived at home with her husband.
Results:
The patient underwent laparotomy and intraoperatively the adrenal mass was found to have infiltrated the left kidney, tail of pancreas and spleen. Therefore, left adrenalectomy, left nephrectomy, distal pancreatectomy and para-aortic lymph node dissection were performed en-bloc (Figure 1). Her post-operative recovery was delayed by an intra-abdominal collection which was treated conservatively with antibiotics. Histopathology results showed SCC which was completed excised, with one of thirty lymph nodes involved. Since the occurrence of primary SCC of the adrenal gland is extremely rare, the patient was followed up with further CT chest, abdomen, and pelvis 3 months post-operatively, however no other lesion was found.
Conclusion:
This case demonstrated an unusual case of SCC in the adrenal gland with no obvious other primary lesion at the time of presentation. To our knowledge this is the second case of this kind to be reported.
{{ help_message }}
{{filter}}