Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Myxoid Adrenocortical Adenoma: Magnetic Resonance Imaging and Pathology Correlation

  • Kim, Tae Un (Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Kim, Suk (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Lee, Jun Woo (Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Lee, Nam Kyung (Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Ha, Hong Koo (Department of Urology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine) ;
  • Park, Won Young (Department of Pathology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine)
  • Received : 2013.09.30
  • Accepted : 2013.12.31
  • Published : 2014.04.01
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Abstract

We report a case of a 74-year-old female with myxoid adrenocortical adenoma which showed different magnetic resonance imaging findings compared to those of a typical adrenocortical adenoma. The myxoid change in the adrenocortical adenoma is a rare form of degeneration. It presents a considerable diagnostic challenge to both radiologists and clinicians because it can mimic other adrenal tumor types on imaging. The MRI findings of the presented case included a high signal intensity on T2-weighted images similar to that of fluid and delayed progressive enhancement.

Keywords

References

  1. Pena CS, Boland GW, Hahn PF, Lee MJ, Mueller PR. Characterization of indeterminate (lipid-poor) adrenal masses: use of washout characteristics at contrast-enhanced CT. Radiology 2000;217:798-802 https://doi.org/10.1148/radiology.217.3.r00dc29798
  2. Haider MA, Ghai S, Jhaveri K, Lockwood G. Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses: does it still have a role? Radiology 2004;231:711-716 https://doi.org/10.1148/radiol.2313030676
  3. Tang CK, Harriman BB, Toker C. Myxoid adrenal cortical carcinoma: a light and electron microscopic study. Arch Pathol Lab Med 1979;103:635-638
  4. Allen PW. Myxoma is not a single entity: a review of the concept of myxoma. Ann Diagn Pathol 2000;4:99-123 https://doi.org/10.1016/S1092-9134(00)90019-4
  5. Forsthoefel KF. Myxoid adrenal cortical carcinoma. A case report with differential diagnostic considerations. Arch Pathol Lab Med 1994;118:1151-1153
  6. Brown FM, Gaffey TA, Wold LE, Lloyd RV. Myxoid neoplasms of the adrenal cortex: a rare histologic variant. Am J Surg Pathol 2000;24:396-401 https://doi.org/10.1097/00000478-200003000-00008
  7. Honda K, Kashima K, Daa T, Gamachi A, Nakayama I, Yokoyama S. Myxoid adrenal cortical adenoma. Pathol Int 2001;51:887-891 https://doi.org/10.1046/j.1440-1827.2001.01287.x
  8. Dundr P, Novak K. Pseudoglandular myxoid adenoma of the adrenal gland. Pathol Res Pract 2003;199:493-496 https://doi.org/10.1078/0344-0338-00452
  9. Bollito ER, Papotti M, Porpiglia F, Terzolo M, Cracco CM, Cappia S, et al. Myxoid adrenocortical adenoma with a pseudoglandular pattern. Virchows Arch 2004;445:414-418 https://doi.org/10.1007/s00428-004-1071-8
  10. Wu JS, Hochman MG. Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology 2009;253:297-316 https://doi.org/10.1148/radiol.2532081199
  11. Bydder GM. Clinical application of gadolinium-DTPA. In: Stark DD, Bradley WG, eds. Magnetic resonance imaging. St. Louis: Mosby, 1988:182-200
  12. Mitchell DG, Crovello M, Matteucci T, Petersen RO, Miettinen MM. Benign adrenocortical masses: diagnosis with chemical shift MR imaging. Radiology 1992;185:345-351 https://doi.org/10.1148/radiology.185.2.1410337
  13. Varghese JC, Hahn PF, Papanicolaou N, Mayo-Smith WW, Gaa JA, Lee MJ. MR differentiation of phaeochromocytoma from other adrenal lesions based on qualitative analysis of T2 relaxation times. Clin Radiol 1997;52:603-606 https://doi.org/10.1016/S0009-9260(97)80252-8
  14. Inan N, Arslan A, Akansel G, Anik Y, Balci NC, Demirci A. Dynamic contrast enhanced MRI in the differential diagnosis of adrenal adenomas and malignant adrenal masses. Eur J Radiol 2008;65:154-162 https://doi.org/10.1016/j.ejrad.2007.03.012
  15. Sakai F, Sone S, Kiyono K, Maruyama A, Ueda H, Aoki J, et al. Intrathoracic neurogenic tumors: MR-pathologic correlation. AJR Am J Roentgenol 1992;159:279-283 https://doi.org/10.2214/ajr.159.2.1632340
  16. Dunnick NR, Castellino RA. Arteriographic Manifestations of Ganglioneuromas. Radiology 1975;115:323-328 https://doi.org/10.1148/115.2.323
  17. Ichikawa T, Ohtomo K, Araki T, Fujimoto H, Nemoto K, Nanbu A, et al. Ganglioneuroma: computed tomography and magnetic resonance features. Br J Radiol 1996;69:114-121 https://doi.org/10.1259/0007-1285-69-818-114
  18. Liu QY, Gao M, Li HG, Lin XF, Huang SQ, Liang BL. Juxtaadrenal schwannoma: dynamic multi-slice CT and MRI findings. Eur J Radiol 2012;81:794-799 https://doi.org/10.1016/j.ejrad.2011.01.082
  19. Suzuki K, Nakanishi A, Kurosaki Y, Nogaki J, Takaba E. Adrenal schwannoma: CT and MRI findings. Radiat Med 2007;25:299-302 https://doi.org/10.1007/s11604-007-0136-4
  20. Takatera H, Takiuchi H, Namiki M, Takaha M, Ohnishi S, Sonoda T. Retroperitoneal schwannoma. Urology 1986;28:529-531 https://doi.org/10.1016/0090-4295(86)90161-5
  21. Sabanegh E Jr, Harris MJ, Grider D. Cavernous adrenal hemangioma. Urology 1993;42:327-330 https://doi.org/10.1016/0090-4295(93)90626-L
  22. Otal P, Escourrou G, Mazerolles C, Janne d'Othee B, Mezghani S, Musso S, et al. Imaging features of uncommon adrenal masses with histopathologic correlation. Radiographics 1999;19:569-581 https://doi.org/10.1148/radiographics.19.3.g99ma07569

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