HMB-45 Negative Adrenal Angiomyolipoma With A Synchronous Adrenal Adenoma – An Unusual Association
DOI:
https://doi.org/10.21276/apalm.2826Keywords:
Adenoma, Adrenal Angiomyolipoma, HMB-45 negativeAbstract
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.
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Copyright (c) 2020 Gayathri G Nair, Sreeja Raju, Joy Augustine, Vijayalakshmi Nair
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