Endocrine Abstracts

Introduction: Leiomyomas are benign tumors originating from the smooth muscle cells. They occur more frequently in the uterus and in the gastrointestinal system. Adrenal leiomyomas are rare tumors arising from the smooth muscle of the adrenal vein and its tributaries.

Case report: Man, 72-years-old, referred to Endocrinology in the context of an adrenal incidentaloma (20 mm maximum diametre) detected in abdominal-pelvic CT performed for the study of splenomegaly. He had arterial hypertension, well controlled with two antihypertensive drugs. Family history was irrelevant and physical examination did not reveal any sing suggestive of adrenal hyperfunctioning. CT scan performed 12 months after diagnosis (January 2013) showed a left adrenal nodule with 25 mm, with density values compatible with atypical adenoma. Biochemical evaluation confirmed that it was nonfunctioning. CT scan was repeated on April 2015 showing a nodule with irregular borders, with 38 mm, with 34HU and slow contrast washout. Considering the lesion characteristics the patient underwent left adrenalectomy. The histological result was in favor of a well-differentiated smooth muscle neoplasm with leiomyoma characteristics. Immunohistochemical study confirmed the diagnosis of leiomyoma with positive cells for alpha-actin and desmin and negative for c-Kit and S100 protein.

Conclusions: The adrenal incidentaloma are often found during the investigation of other diseases not related to adrenal and may be a variety of tumors. The leiomyoma is very rare and should be considered in the differential diagnosis of incidentalomas.