Spinal Adrenal Cortical Adenoma with Oncocytic Features: Report of the First Intramedullary Case and Review of the Literature

International Journal of Surgical Pathology - Tập 12 Số 3 - Trang 259-264 - 2004
David S. Cassarino1, Mariarita Santi2, Arnaldo Ribeiro de Arruda3, Régia Maria do Socorro Vidal Patrocínio4, Maria Tsokos5, Nitya R. Ghatak6, Martha Quezado5
1Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Md. USA
2Department of Pathology, Washington Children’s Hospital, Washington DC
3Department of Surgery, Hospital Das Clinicas, Ceara Brazil
4Biopse Laboratories, Ceara, Brazil
5Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD.
6Neuropathology and Autopsy Service, MCV Hospitals, Virginia Commonwealth University, Richmond, VA

Tóm tắt

Ectopic adrenal cortical neoplasms are extremely rare, and only a few have involved the CNS. We report the first case of an intramedullary oncocytic adrenal cortical neoplasm of the spinal cord with immunohistochemical (IMHC) confirmation. A 27-year-old man presented with progressive lower extremity weakness, spastic paraparesis, decreased reflexes, and hypoesthesia below T10. A spinal myelogram showed cauda equina blockade and obliteration of sacral nerve roots. This prompted emergent surgical intervention. A well-circumscribed, approximately 3 × 2 cm, light brown to tan, intramedullary tumor was identified at the level of the conus medullaris. Histologically, the tumor showed sheets and nests of plump, cytologically bland polygonal cells with abundant eosinophilic cytoplasm. A single mitosis, but no necrosis, was identified. By IMHC, the cells were positive for inhibin, melan-A, and synaptophysin, and negative for GFAP, EMA, cytokeratins, S-100, HMB-45, and chromogranin. Electron microscopy study performed from paraffin-embedded tissues demonstrated abundant mitochondria, and lipid vacuoles. This case confirms the occurrence of adrenal cortical neoplasms in the CNS and is the first report of an intradural, intramedullary adrenal cortical adenoma of the spinal cord, and the first to occur in a male. This tumor should be considered in the differential diagnosis of tumors of the CNS.

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Thông tin
Thông tin xuất bản

International Journal of Surgical Pathology

Tập 12 Số 3

259-264

Thông tin tác giả