PMC6216048_01
Adrenal scan showing a well encapsulated 10 x 9 x 7 cm heterogeneous right adrenal mass with areas of necrosis and calcifications without local invasion.
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The patient was considered to have a non-secreting right adrenal mass for which an adrenal scan was done and showed a well encapsulated 10 x 9 x 7 cm heterogeneous right adrenal mass with areas of necrosis and calcifications without local invasion (Fig. 1).
Laparoscopic view showing adherences between the wall of the IVC and the mass which had a lot of small vessels that were clipped.
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IVC and the renal vein were very adherent to the mass which had a lot of small vessels that were oozing during all the time of the surgery (Fig. 2).
Macroscopic aspect of the tumor before opening it.
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In addition, the mass was extended posterior to the vena cava and we could not do a medial retraction of the IVC since the tumor was adherent to it. In front of these facts, we decided to convert to open surgery by a sub-costal incision (between two trocars) that allowed us to remove the mass safely (Fig. 3).
Histological aspect of the tumor: spindle cells with alternating areas of compact hypercellularity with irregular streams and without atypia or mitosis.
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Histologically, the tumor consisted of spindle cells with alternating areas of compact hypercellularity with irregular streams and without atypia or mitosis (Fig. 4).
The tumor compressing and reducing the adrenal gland (red arrow) which is laminated but intact without histological abnormalities.
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This tumor was completely compressing and reducing the adrenal gland that was laminated but intact without histological abnormalities (Fig. 5).
Immunohistochemical analysis: negative CKAE1-AE3, synaptophysine and chromogranine, but diffusely positive S-100 and CD68 (PGM1) staining across the tumor.
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In contrast to these results, S-100 and CD68 (PGM1) staining were diffusely positive across the tumor (Fig. 6).
Macroscopic aspect of the benign schwannoma after cutting the tumor.
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Thus, the evidences corresponded to a benign schwannoma (Fig. 7).