Adrenocortical neoplasm with myxoid changes and pseudoglandular pattern: A case report and literature review
Adrenocortical neoplasms with myxoid change are very rare. Herein, we report a case of a 67-year-old man with a history of pancreatic adenocarcinoma status post distal pancreatectomy. During follow-up, PET/CT scan revealed a 2.8 cm tumor involving the left adrenal gland, which was resected. Microsco...
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| Veröffentlicht in: | Human Pathology Reports Jg. 41; S. 300783 |
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| Abstract | Adrenocortical neoplasms with myxoid change are very rare. Herein, we report a case of a 67-year-old man with a history of pancreatic adenocarcinoma status post distal pancreatectomy. During follow-up, PET/CT scan revealed a 2.8 cm tumor involving the left adrenal gland, which was resected. Microscopic examination showed a glandular-appearing lesion involving the adrenal cortex, which raised the differential diagnosis of metastatic pancreatic cancer. Initial immunohistochemical stains showed the lesional cells were negative for CK7, focally positive for pan cytokeratin, and retained SMAD4. Additional evaluation showed the tumor cells were diffusely positive for SF-1, Melan-A, CD56; focally positive for calretinin, and inhibin; and negative for CK20, CDX2, TTF-1, and chromogranin. A Ki67 index was 5 %. While these findings excluded pancreatic adenocarcinoma, they raised the differential diagnosis of adrenal cortical adenoma and/or carcinoma. Final diagnosis was myxoid adrenocortical tumor of uncertain malignant potential (MAT-UMP) following consensus review. In this case report and review, we highlight the diagnostic challenges of MAT-UMP, discuss potential pitfalls associated with this diagnosis, and review literature on this unusual entity. |
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| AbstractList | Adrenocortical neoplasms with myxoid change are very rare. Herein, we report a case of a 67-year-old man with a history of pancreatic adenocarcinoma status post distal pancreatectomy. During follow-up, PET/CT scan revealed a 2.8 cm tumor involving the left adrenal gland, which was resected. Microscopic examination showed a glandular-appearing lesion involving the adrenal cortex, which raised the differential diagnosis of metastatic pancreatic cancer. Initial immunohistochemical stains showed the lesional cells were negative for CK7, focally positive for pan cytokeratin, and retained SMAD4. Additional evaluation showed the tumor cells were diffusely positive for SF-1, Melan-A, CD56; focally positive for calretinin, and inhibin; and negative for CK20, CDX2, TTF-1, and chromogranin. A Ki67 index was 5 %. While these findings excluded pancreatic adenocarcinoma, they raised the differential diagnosis of adrenal cortical adenoma and/or carcinoma. Final diagnosis was myxoid adrenocortical tumor of uncertain malignant potential (MAT-UMP) following consensus review. In this case report and review, we highlight the diagnostic challenges of MAT-UMP, discuss potential pitfalls associated with this diagnosis, and review literature on this unusual entity. AbstractAdrenocortical neoplasms with myxoid change are very rare. Herein, we report a case of a 67-year-old man with a history of pancreatic adenocarcinoma status post distal pancreatectomy. During follow-up, PET/CT scan revealed a 2.8 cm tumor involving the left adrenal gland, which was resected. Microscopic examination showed a glandular-appearing lesion involving the adrenal cortex, which raised the differential diagnosis of metastatic pancreatic cancer. Initial immunohistochemical stains showed the lesional cells were negative for CK7, focally positive for pan cytokeratin, and retained SMAD4. Additional evaluation showed the tumor cells were diffusely positive for SF-1, Melan-A, CD56; focally positive for calretinin, and inhibin; and negative for CK20, CDX2, TTF-1, and chromogranin. A Ki67 index was 5 %. While these findings excluded pancreatic adenocarcinoma, they raised the differential diagnosis of adrenal cortical adenoma and/or carcinoma. Final diagnosis was myxoid adrenocortical tumor of uncertain malignant potential (MAT-UMP) following consensus review. In this case report and review, we highlight the diagnostic challenges of MAT-UMP, discuss potential pitfalls associated with this diagnosis, and review literature on this unusual entity. |
| ArticleNumber | 300783 |
| Author | Zhang, Miao Hansel, Donna E. Elsayes, Khaled Guo, Charles C. |
| Author_xml | – sequence: 1 givenname: Miao surname: Zhang fullname: Zhang, Miao email: mzhang8@mdanderson.org organization: Department of Pathology, Division of Pathology & Laboratory Medicine, The University of Texas MD Anderson Cancer Center 1515 Holcombe Blvd, Houston, TX, USA – sequence: 2 givenname: Khaled surname: Elsayes fullname: Elsayes, Khaled organization: Department of Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA – sequence: 3 givenname: Charles C. surname: Guo fullname: Guo, Charles C. organization: Department of Pathology, Division of Pathology & Laboratory Medicine, The University of Texas MD Anderson Cancer Center 1515 Holcombe Blvd, Houston, TX, USA – sequence: 4 givenname: Donna E. surname: Hansel fullname: Hansel, Donna E. organization: Department of Pathology, Division of Pathology & Laboratory Medicine, The University of Texas MD Anderson Cancer Center 1515 Holcombe Blvd, Houston, TX, USA |
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| Cites_doi | 10.3390/biomedicines9020175 10.1097/00000478-200003000-00008 10.5858/2005-129-541-PQCAYM 10.1097/PAS.0b013e3181e2b726 10.1007/s00428-011-1166-y 10.1078/0344-0338-00452 10.1002/dc.24811 10.1007/s00428-004-1071-8 10.3348/kjr.2014.15.2.245 10.1016/j.prp.2017.04.010 10.1016/j.anndiagpath.2008.04.002 10.1016/j.asjsur.2022.10.043 10.1309/AJCP7LO3NAYQKASZ 10.4081/rt.2013.e54 10.1046/j.1440-1827.2001.01287.x 10.4103/0019-5359.40985 |
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