case_images: PMC6216048_01
case_images: Adrenal scan showing a well encapsulated 10 x 9 x 7 cm heterogeneous right adrenal mass with areas of necrosis and calcifications without local invasion.
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case_images: PMC6216048_01_gr1.jpg
case_images: fig0005
case_images: The patient was considered to have a non-secreting right adrenal mass for which an adrenal scan was done and showed a well encapsulated 10 x 9 x 7 cm heterogeneous right adrenal mass with areas of necrosis and calcifications without local invasion (Fig. 1).
case_images: Laparoscopic view showing adherences between the wall of the IVC and the mass which had a lot of small vessels that were clipped.
case_images: gr2.jpg
case_images: PMC6216048_01_gr2.jpg
case_images: fig0010
case_images: IVC and the renal vein were very adherent to the mass which had a lot of small vessels that were oozing during all the time of the surgery (Fig. 2).
case_images: Macroscopic aspect of the tumor before opening it.
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case_images: PMC6216048_01_gr3.jpg
case_images: fig0015
case_images: In addition, the mass was extended posterior to the vena cava and we could not do a medial retraction of the IVC since the tumor was adherent to it. In front of these facts, we decided to convert to open surgery by a sub-costal incision (between two trocars) that allowed us to remove the mass safely (Fig. 3).
case_images: Histological aspect of the tumor: spindle cells with alternating areas of compact hypercellularity with irregular streams and without atypia or mitosis.
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case_images: PMC6216048_01_gr4.jpg
case_images: fig0020
case_images: Histologically, the tumor consisted of spindle cells with alternating areas of compact hypercellularity with irregular streams and without atypia or mitosis (Fig. 4).
case_images: The tumor compressing and reducing the adrenal gland (red arrow) which is laminated but intact without histological abnormalities.
case_images: gr5.jpg
case_images: PMC6216048_01_gr5.jpg
case_images: fig0025
case_images: This tumor was completely compressing and reducing the adrenal gland that was laminated but intact without histological abnormalities (Fig. 5).
case_images: Immunohistochemical analysis: negative CKAE1-AE3, synaptophysine and chromogranine, but diffusely positive S-100 and CD68 (PGM1) staining across the tumor.
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case_images: PMC6216048_01_gr6.jpg
case_images: fig0030
case_images: In contrast to these results, S-100 and CD68 (PGM1) staining were diffusely positive across the tumor (Fig. 6).
case_images: Macroscopic aspect of the benign schwannoma after cutting the tumor.
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case_images: PMC6216048_01_gr7.jpg
case_images: fig0035
case_images: Thus, the evidences corresponded to a benign schwannoma (Fig. 7).