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Updated: Dec 26, 2025

A Novel Method: Super-selective Adrenal Venous Sampling
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Primary adrenal leiomyosarcoma: A case report.

Maria Sakellariou1, Dionysios Dellaportas1, Eirini Grapsa2

  • 1Second Department of Surgery, School of Medicine, National and Kapodistrian University of Athens, Aretaieion University Hospital, 11528 Athens, Greece.

Molecular and Clinical Oncology
|March 20, 2020
PubMed
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This study details a rare adrenal leiomyosarcoma case in a 62-year-old male. Despite initial suspicion of adrenocortical carcinoma, the tumor was diagnosed as adrenal leiomyosarcoma, which showed aggressive metastatic behavior.

Area of Science:

  • Oncology
  • Pathology
  • Radiology

Background:

  • Adrenal leiomyosarcomas are rare mesenchymal tumors originating in the suprarenal region.
  • These tumors are often diagnosed at advanced stages due to their large size at presentation.

Purpose of the Study:

  • To report a rare case of incidentally discovered adrenal leiomyosarcoma.
  • To highlight the diagnostic challenges and aggressive clinical course of this rare tumor.

Main Methods:

  • Case report of a 62-year-old male with an incidentally found left adrenal mass.
  • Diagnostic workup included magnetic resonance imaging (MRI) and hormonal evaluation.
  • Surgical resection (left radical adrenalectomy) followed by histopathological and immunohistochemical analysis.
  • Clinical follow-up included monitoring for metastatic disease.
Keywords:
adrenal glandadrenalectomyleiomyosarcomamalignantneoplasia

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Main Results:

  • MRI revealed a large (10x8.2 cm) heterogeneously enhanced left adrenal mass suspicious for malignancy.
  • Histopathology confirmed a well-differentiated adrenal leiomyosarcoma, positive for desmin and smooth muscle actin.
  • The patient experienced early and aggressive metastatic disease to bone, liver, and lungs postoperatively.
  • Despite radiation therapy and chemotherapy, the patient had progressive metastatic disease 31 months after surgery.

Conclusions:

  • Adrenal leiomyosarcoma can present as an incidentally discovered adrenal mass.
  • Accurate diagnosis requires a combination of imaging, hormonal evaluation, and detailed histopathological analysis.
  • Adrenal leiomyosarcoma can follow an aggressive clinical course with early and widespread metastasis, necessitating multimodal treatment strategies.