Unusual association between adrenal leiomyoma and autoimmune disease

Adrenal leiomyoma is a rare solid tumor of unknown etiology. Here, we present a case of a 38-year-old woman, a known case of Hashimoto's thyroiditis, presented with right adrenal mass incidentally discovered by computed tomography imaging. The mass was non-functioning according to laboratory results, but because the mass increased in size in a follow up visit, she underwent right adrenalectomy. The histological findings confirmed the diagnosis of adrenal leiomyoma, which was supported by a panel of immunohistochemical stains. Surprisingly, there was a dense lymphocytic infiltrate in the background of the tumor, forming germinal centers. Although most of the reported adrenal leiomyoma cases are associated with immune deficiency, none of the previous cases was associated with an autoimmune disease.1 We report a case of an unusual adrenal leiomyoma with a dense lymphocytic infiltrate.