• Jiali Chen, Yan Huang, Jingjing Chen, Xianzhong Qi, Yue Ma, Miaoyan Wang, and Fufeng Liu.
• Department of Pathology, First People's Hospital of Linping District, Hangzhou, China.
• Medicine (Baltimore). 2024 Mar 22; 103 (12): e37452e37452.

BackgroundAdrenal cellular schwannomas are exceptionally rare stromal tumors that are often misdiagnosed due to the lack of specific radiological, serological, or clinical features. In this report, we describe the differential diagnosis of a rare adrenal cellular schwannoma.MethodsA 69-year-old man with a history of persistent hypertension, chronic kidney disease, hypertensive heart disease, and cardiac insufficiency was hospitalized due to bilateral lower extremity edema lasting for 3 months. Plain computed tomography at that time revealed a space-occupying lesion in the right adrenal gland. As serum levels of catecholamines, cortisol, and adrenocorticotropic hormone were within normal ranges, the edema was attributed to the chronic kidney disease and cardiac insufficiency, and the patient was referred to our hospital for surgical treatment. Contrast-enhanced computed tomography revealed heterogeneous enhancement in the adrenal mass indicating pheochromocytoma. An irregularly shaped 5 cm mass with a complete capsule in the right adrenal gland was laparoscopically resected. The postoperative histopathological diagnosis was adrenal cellular schwannoma.ResultsThe postoperative course was unremarkable and the tumor did not recur during 5 years of follow-up.ConclusionAdrenal cellular schwannoma is a very rare tumor that is extremely difficult to preoperatively diagnose. Histological and immunohistochemical analyses are required for differential diagnosis and confirmation. Cellular schwannomas can transform into malignant peripheral nerve sheath tumors, but not often. Consequently, regular postoperative follow-up is required for such patients, especially imaging.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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