Single Centre Based Clinicopathological Experience of Adrenal Tumours Including Some Rare Entities

Abstract

Adrenal tumours are relatively uncommon neoplasms, broadly divided into adrenal cortical and medullary tumours. They show bimodal age distribution. This is a retrospective case series of 36 cases of adrenal tumours over three years (September 2016- August 2019) in NRS Medical College Kolkata, West Bengal, India. Apart from Haematoxylin and Eosin (H&E) staining relevant Immunohistochemistry (IHC) (synaptophysin, Ki-67, Human Melanoma Black 45 (HMB 45) were done for proper histopathological diagnosis. Amongst 36 cases, 12 cases (34%) were myelolipoma, five cases (14%) were neuroblastoma, six cases (17%) of adrenocortical adenoma, two cases (06%) adrenocortical carcinoma, five cases (14%) pheochromocytoma, two cases (06%) mature teratoma, one case (03%) of epitheiloid PECOMA (Perivascular epithelioid cell tumour), one case haemorrhagic pseudocyst (03%) and two cases (06%) were metastasis from renal cell carcinoma. Eleven patients had specific hormonal symptoms. Bimodal age distribution with 10 cases in younger than 14 years, eight cases in more than 50 years and rest 18 cases were in range of 14-50 years. Overall male: female ratio is 5:4 but myelolipoma was common in female. We have encountered few rare entities-Epithelioid PECOMA (angiomyolipoma), Pheochromocytoma with Von Hippel-Lindau (VHL), Receptor for Neurotrophic Factor (RET) Mutation and uncommon presentation with Cushing’s Syndrome, one Adrenal Oncocytoma and two Mature Teratoma.