Adas Mine, Ozulker Filiz, Adas Gokhan, Koc Bora, Ozulker Tamer, Sahin Ilknur Mansuroglu
Department of Endocrinology, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Department of Nuclear Medicine, Okmeydani Training and Research Hospital, Istanbul, Turkey.
Case Rep Gastroenterol. 2013 Oct 5;7(3):420-7. doi: 10.1159/000355871. eCollection 2013.
Adrenal schwannoma is an extremely uncommon cause of incidentaloma. It originates from neural sheath Schwann cells of the adrenal gland. We report the case of a left adrenal schwannoma incidentally discovered in a 32-year-old woman during examination of bloated feeling and stomach ache. The patient was incidentally found to have a left adrenal mass of 9 cm on abdominal ultrasonography. Computed tomography (CT) of the abdomen and [(18)F] fluorodeoxyglucose positron emission tomography (PET) were also performed. Metabolic evaluation was unremarkable. Due to the large size of the tumor, left adrenalectomy was performed. The postoperative course was uneventful. Histological examination established the diagnosis of schwannoma. This diagnosis was supported by immunohistochemistry of S-100 and vimentin positivity. In conclusion, adrenal schwannoma is an extremely rare entity and can grow considerably in size. The present case report emphasizes that clinicians should be aware of the possibility of retroperitoneal schwannoma. Total excision of benign schwannoma is associated with a favorable outcome. To our knowledge, there are case reports of schwannoma with CT and magnetic resonance imaging findings in the literature, although this is the first schwannoma case with PET-CT imaging.
肾上腺神经鞘瘤是偶发瘤极为罕见的病因。它起源于肾上腺的神经鞘雪旺细胞。我们报告一例32岁女性,在因腹胀和腹痛进行检查时偶然发现左侧肾上腺神经鞘瘤。腹部超声检查偶然发现该患者左侧肾上腺有一个9厘米的肿块。还进行了腹部计算机断层扫描(CT)和[(18)F]氟脱氧葡萄糖正电子发射断层扫描(PET)。代谢评估无异常。由于肿瘤体积较大,遂行左侧肾上腺切除术。术后病程顺利。组织学检查确诊为神经鞘瘤。S - 100和波形蛋白阳性的免疫组织化学结果支持了这一诊断。总之,肾上腺神经鞘瘤是一种极其罕见的疾病,且可长得相当大。本病例报告强调临床医生应意识到腹膜后神经鞘瘤的可能性。良性神经鞘瘤的完全切除与良好预后相关。据我们所知,文献中有神经鞘瘤的CT和磁共振成像表现的病例报告,尽管这是首例有PET - CT成像的神经鞘瘤病例。