case_images: PMC4779821_01
case_images: CT scan showing 11.3 cm x 9.7 cm right adrenal mass with scattered calcifications.
case_images: CRIONM2016-5204092.001.jpg
case_images: PMC4779821_01_CRIONM2016-5204092.001.jpg
case_images: fig1
case_images: CT scan confirmed an 11.3 x 9.4 cm right adrenal mass with scattered calcifications consistent with adrenal CA (Figure 1). 24-hour urinary catecholamines, metanephrines, plasma cortisol, and aldosterone were normal.
case_images: PMC4779821_02
case_images: Thick-walled blood vessels and smooth muscle spindle cells interspersed among numerous adipocytes (magnification 200x, hematoxylin and eosin stain).
case_images: CRIONM2016-5204092.002.jpg
case_images: PMC4779821_02_CRIONM2016-5204092.002.jpg
case_images: fig2
case_images: The 626 g, 13 x 12 x 9 cm specimen contained adipose tissue, thick walled blood vessels, and scattered foci of spindle cells with areas of hemorrhage and calcifications on H&E stain (Figure 2).
case_images: PMC4779821_03
case_images: Complex right adrenal mass on MRI with no evidence of invasion.
case_images: CRIONM2016-5204092.003.jpg
case_images: PMC4779821_03_CRIONM2016-5204092.003.jpg
case_images: fig3
case_images: MRI clarified the lesion as adrenal with no invasion of surrounding structures (Figure 3).
case_images: Right adrenal PEComa. It was a 14.5 x 12 x 7 cm fleshy tumor with necrosis and hemorrhage.
case_images: CRIONM2016-5204092.004.jpg
case_images: PMC4779821_03_CRIONM2016-5204092.004.jpg
case_images: fig4
case_images: The mass was excised and sent to pathology (Figure 4).
case_images: PMC4779821_04
case_images: Focal alveolar pattern. These areas are suggestive of an alveolar soft part sarcoma.
case_images: CRIONM2016-5204092.005.jpg
case_images: PMC4779821_04_CRIONM2016-5204092.005.jpg
case_images: fig5
case_images: The tumor replaced the adrenal gland in its entirety but the capsule was intact, with various growth patterns (Figures 5 and 6).
case_images: PAS stains carbohydrate moieties such as glycogen. This was a granular material more consistent with a PEComa.
case_images: CRIONM2016-5204092.006.jpg
case_images: PMC4779821_04_CRIONM2016-5204092.006.jpg
case_images: fig6
case_images: The tumor replaced the adrenal gland in its entirety but the capsule was intact, with various growth patterns (Figures 5 and 6).