Benign adrenal and suprarenal retroperitoneal schwannomas can mimic aggressive adrenal malignancies: case report and review of the literature

  • Wilson Mitchell P.
    Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada.
  • Katlariwala Prayash
    Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada.
  • Huang Jingyang
    Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Canada.
  • Low Gavin
    Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada.
  • Wiebe Edward
    Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada.

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<p>The suprarenal retroperitoneum and adrenal gland is a rare site of origin for benign schwannomas which frequently present as larger and more aggressive lesions than schwannomas identified elsewhere. These tumors are often surgically excised. We present a case of an 81-year-old asymptomatic man presenting with an incidental 10 cm left suprarenal retroperitoneal mass identified on CT. The mass was indiscernible from the adrenal gland, demonstrating heterogeneous enhancement with a centrally cystic/necrotic core, and punctate calcifications. Subsequent core needle biopsy demonstrated a benign adrenal schwannoma. The lesion has been managed conservatively with imaging follow up and without complication. DISCUSSION: Our review of the literature identifies 121 reported in vivo benign adrenal and suprarenal schwannomas published to date with imaging features available for 90 cases (74%). All cases were encapsulated with the average size measuring over 6.5 cm. Fifteen percent (13/84) of reported lesions measured over 10 cm at presentation. Punctate calcification was present in 50% (26/52) of reporting cases. Nearly 50% (40/86) of cases demonstrate cystic/necrotic appearances on imaging. Despite aggressive appearances, our case demonstrates that biopsy and surveillance may represent a reasonable alternative to surgery in suboptimal surgical candidates.</p>

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  • Intractable & Rare Diseases Research

    Intractable & Rare Diseases Research 9 (3), 156-162, 2020-08-31

    特定非営利活動法人 バイオ&ソーシャル・サイエンス推進国際研究交流会

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