Abstract
The adrenal gland is a common metastatic site of squamous cell carcinoma (SCC), however primary adrenal SCC has not been reported in literature. In this case report, we presented the first case of primary adrenal SCC. A 53-year-old man presented with chronic right flank pain. Abdominopelvic computed tomography (CT) confirmed left kidney agenesis and a soft tissue density mass measuring about 40×30 mm in the right adrenal gland. Adrenal functional assessment including metanephrine, normetanephrine and vanillyl mandelic acid were normal. The patient underwent surgical resection of right adrenal mass. Pathology report revealed adrenal SCC. Immunohistochemistry evaluation demonstrated positive staining for P63, CK, CD10, CK7, chromogranin, neuron specific enolase, and negative staining for alpha-inhibin, neurofilament, CK20, and tyrosine hydroxylase that were compatible with SCC. All other assessments to find primary site of SCC including upper and lower gastro-intestinal endoscopy, chest CT scan, positron emission tomography scan, and bronchoscopy demonstrated normal findings. To our knowledge, this is the first case of primary adrenal SCC without any evidence of metastatic nature of such adrenal involvement by SCC.
Highlights
Squamous cell carcinoma (SCC) of the adrenal gland is usually diagnosed as a metastatic disease of another organ origin such as lung (Toogood et al, 2014)
Immunohistochemistry (IHC) evaluation demonstrated the nature of the right adrenal mass - squamous cell carcinoma
In IHC assessment, we found positive staining for P63, CK, CD10, CK7, chromogranin, neuron specific enolase, and negative for alpha-inhibin, neurofilament, CK20, and tyrosine hydroxylase (Figure 3)
Summary
Squamous cell carcinoma (SCC) of the adrenal gland is usually diagnosed as a metastatic disease of another organ origin such as lung (Toogood et al, 2014). The management of the local and metastatic SCC in adrenal gland could be different. Due to lack of data regarding the effective treatment for primary involvement of adrenal gland with SCC, we present this case report, a single kidney patient with primary adrenal SCC and no evidence of tumour origin in other organs to elucidate surgical local management of such rare tumour. Ultrasonography imaging revealed a 40×30 mm hypoechoic lobulated mass at the anatomical site of right adrenal incidentally unrelated to the patient’s symptoms. Left kidney was not found on ultrasonography in anatomical site. Left adrenal was found in anatomical site (Figure 1). The invasive tumour cells invaded to the most parts of adrenal gland with tiny remnant of normal adrenal tissue
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