The adrenocortical adenoma: A case report

Introduction: Incidental suprarenal tumors with equivocal diagnostic studie s frequently present difficulties in differentiation and organ identificati on. In such cases explorative laparatomy and pathologic workup become neces sary for an accurate diagnosis. Case report: In a 60-year-old patient with arterial hypertension a 10.6 x 9 .6 cm inhomogeneous tumor at the upper pole of the right kidney was an inci dental sonographic finding. Diagnostic studies such as intravenous pyelogra phy (IVP) and computed tomography (CT) did not clarify dignity or whether t he tumor originated in the kidney or the adrenal gland. Urine studies of ca techolamine metabolites were negative. Intraoperatively an adrenal tumor wa s identified and removed. Pathologic diagnostic workup proved difficult bec ause of overlapping expression of immunohistochemical markers (e.g. neuron- specific enolase, synaptophysine, adrenocortical marker D11, Ki-67) in pheo chromocytoma, adrenocortical carcinoma and adrenocortical oncocytoma. Conclusion: The adrenocortical oncocytoma is a rare entity challenging both the clinician and the pathologist.