HMB-45 Negative Adrenal Angiomyolipoma With A Synchronous Adrenal Adenoma — An Unusual Association

Authors

  • Gayathri G Nair Amala Institute of Medical Sciences, Kerala, India
  • Sreeja Raju Amala Institute of Medical Sciences, Kerala, India
  • Joy Augustine Amala Institute of Medical Sciences, Kerala, India
  • Vijayalakshmi Nair Amala Institute of Medical Sciences, Kerala, India

DOI:

https://doi.org/10.21276/apalm.2826

Keywords:

Adenoma, Adrenal Angiomyolipoma, HMB-45 negative

Abstract

Background:

Angiomyolipoma (AML) is an uncommon mesenchymal tumour usually found in the kidney. The most common extrarenal site is usually the liver. We report a case of adrenal AML with a predominant vascular component co-existing with an adrenal adenoma.

Case report:

A fifty-year-old male presented with two months history of dysuria. Computed tomography showed a heterogeneous lesion involving the right adrenal gland abutting the right kidney and adjacent liver capsule.  Urine noradrenaline levels were elevated.  Adrenalectomy specimen showed an encapsulated mass measuring 8 x 5 x3.5 cm with a lobulated, grey to tan brown cut surface with areas of haemorrhage and tiny cystic spaces. Another yellowish nodule measuring 1.3 x 1.2 x 1 cm was also noted at one pole. Microscopy showed a neoplasm composed predominantly thick-walled vascular channels admixed with foci of smooth muscle bundles and adipocytes. Yellowish nodule showed features of adrenal adenoma.   HMB-45 was negative and CD34 positivity highlighted the thick and thin walled vessels.

Conclusion:

We present the very first case of HMB-45 negative adrenal AML with a predominant vascular component and a synchronous adrenal adenoma.

Author Biographies

  • Gayathri G Nair, Amala Institute of Medical Sciences, Kerala, India

    Department of Pathology

  • Sreeja Raju, Amala Institute of Medical Sciences, Kerala, India

    Department of Pathology

  • Joy Augustine, Amala Institute of Medical Sciences, Kerala, India

    Department of Pathology

  • Vijayalakshmi Nair, Amala Institute of Medical Sciences, Kerala, India

    Department of Pathology

References

1. Hussain T, Al-Hamali S. Pathophysiology and management aspects of adrenal angiomyolipomas. The Annals of The Royal College of Surgeons of England. 2012;94(4):224-226.
2. Ghimire O, Wenzheng L, Huaping L, Wenguang L, Yigang P, Jiale H. Angiomyolipoma of the Adrenal Gland: A Report of Two Cases and Review of the Literature. American Journal of Case Reports. 2017;18:989-994.
3. Sindhwani G,Jain A,Arora M,Patel V,Bhandari S,Ranga A.original article of renal angiomyolipomas: syndromic association, radiological diversity and management. International Journal of Scientific Research. 2017;6(9):174-177.
4. Lin C, Tsai C, Kau H, Yu W, Kao S, Liu C. HMB-45 negative angiomyolipoma of the orbit: a case report and review of the literature. BMC Ophthalmology. 2016;16(1).
5. Godara R, Vashist M, Singla S, Garg P, Sen J, Mathur S et al. Adrenal angiomyolipoma: A rare entity. Indian Journal of Urology. 2007;23(3):319.
6. Sharma A, Khullar R, Soni V, Baijal M, Chowbey P, Goswami A. Adrenal angiomyolipoma: A case report and review of literature. Journal of Minimal Access Surgery. 2014;10(4):213.
7. C. R. J, Menon D, Augustine J, Abdul Siyad A. Epithelioid Angiomyolipoma of Liver with an Inflammatory Component: A Case Report. Case Reports in Hepatology. 2013;2013:1-3.
8. Hu H, Xi X. Giant Adrenal Angiomyolipoma. The Journal of Clinical Endocrinology & Metabolism. 2012;97(11):3835-3836.
9. Aziz M, Tabrez M. A Giant Angiomyolipoma of the Adrenal Gland: A Rare Case Report with Review of Literature. New Indian Journal of Surgery. 2016;7(3):337-339.

Downloads

Published

01-09-2020

Issue

Section

Case Report

How to Cite

1.
HMB-45 Negative Adrenal Angiomyolipoma With A Synchronous Adrenal Adenoma — An Unusual Association. Ann of Pathol and Lab Med [Internet]. 2020 Sep. 1 [cited 2025 Dec. 13];7(8):C99-102. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/2826