PMC7218959_01
High-resolution, contrast abdominal CT scan, at diagnosis (a) and 16 months after right adrenalectomy (b). (a) Axial and coronal views showing a large, heterogeneous right adrenal mass and an atrophic left adrenal gland. (b)Axial and coronal views showing a large, heterogeneous hepatic mass and a somewhat hypoplastic left adrenal gland.
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fig1
Pituitary magnetic resonance imaging (MRI) was normal, but a thoracoabdominal, high-resolution, contrast CT scan disclosed a heterogeneous, mostly hypodense, 9.3 x 7.6 x 10.4 cm lesion arising from the right adrenal gland (27-61 HU); the left adrenal gland looked atrophied (Figure 1(a)).
(a) Macroscopic view of the excised tumor. (b) Hematoxylin and eosin stain of the tumor (10x) showing three cellular patterns: "A" corresponds to the medullary neuroendocrine component, "C" corresponds to the cortical component, and "B" shows cells of an intermediate phenotype. (c, d) Double-label immunohistochemistry, with antibodies to CgA linked to horseradish peroxidase (brown) and antibodies against inhibin linked to alkaline phosphatase (red).
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fig2
A control CT scan of her abdomen revealed two large, metastatic liver lesions, measuring 6.4 and 8 cm, respectively, as well as a 7.6 cm peritoneal implant (Figure 2(b)).