PMC4202765_01
Left suprarenal mass and metastasis near the posterior abdominal wall.
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April 2011, a 68 yr old Caucasian male was admitted to the surgery clinic at the General Hospital "Perrino" in Brindisi (Italy) because of a pain in the left thorax. A CT scan showed a suprarenal mass of 7 cm with intra-parenchymal calcifications and dishomogeneous enhancement in contact with the gastric wall, left renal vein and splenic vessels (Fig. 1 ).
Clear cells as hyperplastic adrenal tissue (bottom) and neoplastic vascular channels
(top) with malignant endothelial epithelioid cells (hematoxylin-eosin x32).
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These channels infiltrated the surrounding adrenal tissue, which was diffusely hyperplastic; they had an irregular shape and formed intercommunicating sinusoids with endothelial papillae (Fig. 2).
Immunohistochemical staining for CD31 antigen. Note intense brown coloration of the
membrane of the endothelial neoplastic cells with residual negative adrenal tissue
(x40).
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Immunohistochemically, the neoplastic cells were strongly and diffusely positive for platelet endothelial cell adhesion molecule (PECAM-1) also known as cluster of differentiation 31 (CD31) (Fig. 3), Human von Willebrand Factor (Factor VIII-related antigen) and focally positive for CKAE1AE3.