PMC5577075_01
(A) Significant and segmented calcification in the Achilles tendon on X-ray. (B) Neoplastic lesion in the adrenal gland on CT. The maximum diameter was approximately 8 cm, and the inside showed a mosaic pattern, including a substantial ratio of low-density area. (C) Neoplastic lesion in the adrenal gland on MRI. The maximum diameter was approximately 8 cm, and it had a high-density area due to calcification.
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Achilles tendon, which was typical of Werner syndrome. Furthermore, during a preoperative examination of the ulcer, a right adrenal tumor was found. As shown in Fig. 1B, computed tomography (CT) revealed a neoplastic lesion. Magnetic resonance imaging (MRI) also showed a neoplastic lesion including high-density area due to calcification (Fig. 1C).
(A) (Upper panel) The maximum diameter of the resected specimen was 10.5 cm. (Middle and lower panel) The cut surface was solid and myxomatous. (B) (Upper and middle panel) Dysplastic epithelium cells on Hematoxylin and Eosin staining, indicating myxoid adrenocortical carcinoma. The nuclei were relatively small, and most of the cytoplasm was eosinophilic. Necrosis and capsular invasion were observed, although no abnormal mitoses were observed. Thus, the modified Weiss' score was 4, prompting a diagnosis of adrenal cortex cancer. (Lower panel) Positive staining (brown) was observed on immunostaining for SF-1, a marker of adrenal cortex tumor.
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As shown in Fig. 2A, the maximum diameter was 10.5 cm in the resected specimen, and the cut surface was solid and myxomatous. As shown in the upper and middle panels in Fig. 2B, dysplastic epithelium cells were observed on Hematoxylin and Eosin (HE) staining, indicating myxoid adrenocortical carcinoma. In addition, positive staining (brown) was observed on immunostaining for steroidogenic factor-1 (SF-1), a marker of adrenal cortex tumor (low panel in Fig. 2B).