Giant adrenal germ cell tumor in a 59-year-old woman: A case report and review of the literature

Abstract

Adrenal germ cell tumor is very rare. We report a case of a 59-year-old woman who presented with right flank discomfort. The laboratory examinations were basically normal. Chest computed tomography showed right pleural effusion. Abdominal computed tomography scan revealed a large mass on the right adrenal gland. The patient underwent adrenalectomy. Histopathologic examination and immunohistochemical findings were consistent with mixed germ cell tumor. Three months later following operation, the patient was admitted to our hospital again with chest tightness and shortness of breath. The chest CT showed right pleural effusion recurrence and enlargement of mediastinal lymph nodes and right hilar lymph nodes. The patient had the right supraclavicular lymphadenectasis on physical examination. Fine needle aspiration cytology from the supraclavicular lymph nodes showed groups of malignant tumor cells. The patient died within 6 months postoperatively. In this case, the lymph node pathway plays an important role in the metastatic procedure.