J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Case Report

Volume 5, Number 5, October 2015, pages 304-308

Adrenal Leiomyoma Mimicking Adrenal Malignancy: Diagnostic Challenges and Review of Literature

Figure 1. Contrast-enhanced computed tomography (CT) of abdomen showing a large left-sided adrenal mass measuring 12.2 × 10.3 × 8.0 cm.

Figure 2. (A) Post-surgical resected specimen showing well-encapsulated adrenal mass. (B) Resected specimen’s cut surface showing typical whorling appearance classical of leiomyoma.

Figure 3. (A) Histopathology of the resected adrenal tumor showing bundles of smooth muscle cells diagnostic of leiomyoma (hematoxylin & eosin stain, × 200). (B) Higher magnification showing hyaline degeneration within the leiomyoma (hematoxylin & eosin stain, × 400).

**Table 1.** Profile of Patients With Adrenal Leiomyoma Reported in Literature as Compared to the Present Report
S. No.	Reported cases	Age (years)	Sex	Tumor characteristics	HIV status	EBV status
^aFunctional refers to the functional status of the tumor, viz. its ability to secrete one or more hormones either from the adrenal cortex or medulla. ^bFor tumors with single value, it represents the largest diameter. *The 24-h urinary vanillylmandelic acid was normal. Plasma normetanephrine was increased, which is commonly known to be false-positive. NA: not available; HIV: human immunodeficiency virus; EBV: Epstein-Barr virus; L: left; R: right.
1	Lin et al [1]	31	Female	No	110 × 90 × 70	Positive	Negative
2	Nishida et al [2]	48	Female	No	55 × 45 × 50	Negative	Negative
3	Alteer et al [3]	40	Male	No	49 × 55 × 60	Positive	Positive
4	Chang et al [4]	53	Female	No	55 × 45 × 35	Positive	Negative
5	Radin et al [5]	28	Female	NA	30	Positive	Negative
6	Jimenez-Heffernan et al [6]	2	Male	NA	70 × 50 × 50	Positive	Positive
7	Mouchet et al [7]	10	Female	NA	50 × 40 × 30	Negative	Negative
8	Gibbs et al [8]	49	Female	No	30 × 35 × 20	Negative	Negative
9	Jacobs et al [9]	65	Female	No	50 × 31 × 42	Negative	Negative
10	Parola et al [10]	35	Female	NA	35	Positive	Negative
11	Goldman et al [11]	72	Male	No	90 × 70 × 60	Negative	Negative
12	Dahan et al [12]	32	Male	No	30	Positive	Negative
13	Rosenfeld et al [13]	11	Female	NA	L: 50, R: 30	Positive	Negative
14	Demirel et al [14]	15	Male	No	L: 40 × 50 × 35 R: 80 × 50 × 30	Negative	Negative
15	Chao et al [15]	40	Female	No	NA	Negative	Negative
16	Jurczak et al. [16]	56	Male	No	72	Negative	Negative
17	Al-Masri et al [17]	38	Female	NA	NA	Negative	Negative
18	Parelkar et al [18]	11	Female	No*	L: 43 × 35 × 30 R: 90 × 70 × 40	Negative	Positive
19	Present report	42	Female	No	120 × 100 × 80	Negative	Negative

Table 1. Profile of Patients With Adrenal Leiomyoma Reported in Literature as Compared to the Present Report

S. No.

Reported cases

Age (years)

Sex

Tumor characteristics

HIV status

EBV status

Functional^a

Size (mm)^b

^aFunctional refers to the functional status of the tumor, viz. its ability to secrete one or more hormones either from the adrenal cortex or medulla. ^bFor tumors with single value, it represents the largest diameter. *The 24-h urinary vanillylmandelic acid was normal. Plasma normetanephrine was increased, which is commonly known to be false-positive. NA: not available; HIV: human immunodeficiency virus; EBV: Epstein-Barr virus; L: left; R: right.

Lin et al [1]

Female

110 × 90 × 70

Positive

Negative

Nishida et al [2]

Female

55 × 45 × 50

Negative

Alteer et al [3]

Male

49 × 55 × 60

Positive

Chang et al [4]

Female

55 × 45 × 35

Positive

Negative

Radin et al [5]

Female

Positive

Negative

Jimenez-Heffernan et al [6]

Male

70 × 50 × 50

Positive

Mouchet et al [7]

Female

50 × 40 × 30

Negative

Gibbs et al [8]

Female

30 × 35 × 20

Negative

Jacobs et al [9]

Female

50 × 31 × 42

Negative

Parola et al [10]

Female

Positive

Negative

Goldman et al [11]

Male

90 × 70 × 60

Negative

Dahan et al [12]

Male

Positive

Negative

Rosenfeld et al [13]

Female

L: 50, R: 30

Positive

Negative

Demirel et al [14]

Male

L: 40 × 50 × 35
R: 80 × 50 × 30

Negative

Chao et al [15]

Female

Negative

Jurczak et al. [16]

Male

Negative

Al-Masri et al [17]

Female

Negative

Parelkar et al [18]

Female

No*

L: 43 × 35 × 30
R: 90 × 70 × 40

Negative

Positive

Present report

Female

120 × 100 × 80

Negative