PMC3971559_01
Magnetic resonance images of a 9 cm right adrenal leiomyosarcoma. T1-weighted images in coronal section (a) and transverse section show a homogenous solid mass in the right suprarenal area. (c) Macroscopic appearance of roundish, fibrous neoplasia. (d) Six months after right adrenalectomy, postoperative abdominal computerized tomography demonstrated no signs of local recurrence.
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Upon abdominal magnetic resonance imaging (MRI), a 90 x 65 mm hypervascular solid mass originating from the right adrenal gland and extending to the right hepatic lobe was observed, with intense contrast uptake on postcontrast images (Figures 1(a) and 1(b)). The mass, which had not infiltrated into adjacent structures, was completely dissected, and the specimen was sent for histopathological examination (Figure 1(c)). He did not encounter any medical problem during his 8-month-long follow-up period, and abdominal CT performed at the 6th postoperative month did not reveal any evidence of recurrence or metastatic mass lesion (Figure 1(d)).
(a) Microscopic details of tumor:infiltration of inflammatory cells and spindle-shaped neoplastic cells (H and E, x100). (b) Positive Smooth Muscle Actin (SMA) immunostaining (x100). (c) Positive Caldesmon immunostaining (x100). (d) Negative Anaplastic Lymphoma Kinase (ALK) immunostaining (x200).
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In light of these findings, a diagnosis of low-grade leiomyosarcoma was made (Figure 2).