Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
View/Download PDF

Translate this page into:

Letter to the Editor
34 (
2
); 204-204
doi:
10.4103/ijn.ijn_278_23

An Uncommon Malignant Suprarenal Mesenchymal Tumor

Department of Pathology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India
Corresponding author: Dr. Prachi, Department of Pathology, Dharamshila Narayana Superspeciality Hospital, New Delhi, India. E-mail: prachipath123@gmail.com
Licence
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

How to cite this article: Prachi, Aiyer HM, Sharma G. An Uncommon Malignant Suprarenal Mesenchymal Tumor. Indian J Nephrol. 2024;34:204. doi: 10.4103/ijn.ijn_278_23

Dear Editor,

Primary adrenal leiomyosarcoma is a rare malignant tumor. Metastatic adrenal leiomyosarcoma and extension from the retroperitoneum are more frequent. Leiomyosarcoma occurs primarily in the myometrium, retroperitoneum, and soft tissues of the extremities. Herein we report a case in a 31 year old female who presented with abdominal pain. Contrast-enhanced computed tomography (CECT) and contrast-enhanced magnetic resonance imaging (CEMRI) abdomen revealed a large heterogeneously enhancing mass in the right suprarenal region abutting the surrounding structures such as liver, superior pole of right kidney, adjacent inferior vena cava, second part of duodenum, and right renal vein, causing its upliftment [Figure 1a]. Further, she underwent resection of the mass along with right nephrectomy. Pathological findings revealed a nonencapsulated mass measuring 8.5 × 5.5 × 4.5 cm. Cut surface appeared fleshy with hemorrhagic and necrotic areas [Figure 1b]. Microscopically, solid pattern of spindle cells showing marked pleomorphism with 30% areas of necrosis and 10–12 muscle fibers/10 high power fields, with compressed adrenal gland at the periphery was seen [Figure 1c]. Immunohistochemically, intense positivity for desmin, smooth muscle actin [Figure 1d], caldesmon, and vimentin was observed. Considering the aforementioned features, a diagnosis of conventional primary leiomyosarcoma of the adrenal gland, FNCLCC Grade 2 was rendered. After 15 months of follow-up, the patient remained free of recurrence. Adrenal leiomyosarcomas are rare tumors, usually diagnosed at an advanced stage due to nonspecificity of symptoms, contributing to poor prognosis. The gold standard for treatment is surgical excision, followed by chemotherapy and radiotherapy.

Figure 1:
Images of Primary adrenal leiomyosarcoma. (a) Imaging showing a large heterogeneously enhancing mass in the right suprarenal region abutting the surrounding structures. (b) Gross photograph of right nephrectomy specimen with a well defined fleshy suprarenal mass. (c) Microphotograph showing solid pattern of spindle cells showing marked pleomorphism and focal necrosis (H and E X100). (d) Immunoreactivity for Smooth Muscle actin (IHC stain for SMA X400).

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Conflicts of interest

There are no conflicts of interest.

Financial support and sponsorship

Nil.


Fulltext Views
61

PDF downloads
53
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections