case_images: PMC7103033_01
case_images: CT abdomen without contrast showing a large, right suprarenal vs. adrenal mass (arrow).
case_images: CRIM2020-5131736.001.jpg
case_images: PMC7103033_01_CRIM2020-5131736.001.jpg
case_images: fig1
case_images: Computed tomography (CT) scan of the abdomen without contrast revealed a right suprarenal vs. renal mass measuring 16 x 17 x 20 cm (Figure 1).
case_images: MRI of the abdomen showing a large, right abdominal mass from the unclear origin (arrow).
case_images: CRIM2020-5131736.002.jpg
case_images: PMC7103033_01_CRIM2020-5131736.002.jpg
case_images: fig2
case_images: The origin of this mass (renal vs. adrenal) was indistinguishable on MRI image due to large tumor burden (Figure 2).
case_images: (a) Necrotic mass involving the adrenal gland and perinephric soft tissue. (b) Malignant angiomyolipoma with large tumor cells with abundant eosinophilic cytoplasm. (c) Melan-A/Mart-1 immunohistochemical stain positive within the tumors cells.
case_images: CRIM2020-5131736.003.jpg
case_images: PMC7103033_01_CRIM2020-5131736.003.jpg
case_images: fig3
case_images: Subsequently, the patient underwent total right adrenalectomy with en bloc right nephrectomy and resection of regional lymph nodes (Figure 3(a)). These cells are arranged in variably sized nodules with fibrous septae, prominent alveolar growth pattern, with admixed chronic inflammation and extensive necrosis (Figure 3(b)). Immunohistochemistry showed expression of Melan-A/MART-1 (Figure 3(c)), synaptophysin, HMB-45, and CD10 (focal) by tumor cells, but negative expression of PAX8, CK7, smooth muscle actin, inhibin, chromogranin, calretinin, SOX10, and S100.