Abnormal Adrenal Mass Presents as Proximal Epithelioid Sarcoma

Area of Science:

• Oncology
• Pathology

Background:

• Epithelioid sarcoma (ES) is a rare malignant mesenchymal neoplasm, constituting less than 1% of soft-tissue sarcomas.
• Adrenal gland involvement by ES is exceptionally rare, with only two prior reported cases in the literature.

Observation:

• This report details an incidental left adrenal mass discovered via CT imaging in an 82-year-old female presenting with right flank pain.
• The patient underwent surgical resection, leading to a definitive diagnosis of epithelioid sarcoma through histopathological examination.

Findings:

• Histopathological analysis revealed characteristic epithelioid cells with rhabdoid morphology and moderate eosinophilic cytoplasm.
• Immunohistochemical staining showed positive results for epithelial markers, cytokeratins, vimentin, and CD34, along with a loss of INI-1 expression.

Implications:

• The aggressive nature of epithelioid sarcoma necessitates prompt diagnosis and management.
• Wide surgical excision remains the standard treatment for epithelioid sarcoma due to limited therapeutic options and aggressive behavior.