Benign adrenal and suprarenal retroperitoneal schwannomas can mimic aggressive adrenal malignancies: case report and review of the literature
- Resource Type
- Authors
- Jingyang Huang; Prayash Katlariwala; Mitchell P Wilson; Edward Wiebe; Gavin Low
- Source
- Intractable Rare Dis Res
- Subject
- 0301 basic medicine
medicine.medical_specialty
Retroperitoneal mass
medicine.diagnostic_test
Adrenal gland
business.industry
Case Report
General Medicine
030105 genetics & heredity
Schwannoma
medicine.disease
Malignancy
Asymptomatic
Lesion
03 medical and health sciences
0302 clinical medicine
medicine.anatomical_structure
Biopsy
medicine
Radiology
medicine.symptom
Complication
business
030217 neurology & neurosurgery
- Language
- ISSN
- 2186-361X
2186-3644
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.