Adrenal adenoma mimicking angiomyolipoma: A diagnostic pitfall

Angiomyolipoma is a mesenchymal tumor that originates predominantly from perivascular epithelioid cells and is generally considered benign. It is commonly found in the kidneys and rarely in extrarenal locations. Herein, we report a case of angiomyolipoma misdiagnosed as right adrenal angiomyolipoma. A 69-year-old male was diagnosed with a space-occupying lesion in the right adrenal gland. Preoperative abdominal computed tomography showed a 38 × 28-mm non-uniformly enhanced mass in the right adrenal gland. We performed laparoscopic resection of the right adrenal mass. The procedure was successful, and the tumor was completely removed. Based on the initial postoperative pathological report, the lesion was diagnosed as an angiomyolipoma. However, after being verified and certified by a national-level pathology center, this diagnosis was determined to be incorrect. The final pathological diagnosis was adrenal adenoma. For such difficult-to-distinguish pathological diagnoses, routine immunohistochemical identification is recommended. In this case, surgical management of a 4-cm adrenal mass resulted in a favorable treatment outcome. We report this case to draw clinical attention to the therapeutic value of tumors measuring 3-4 cm.