Solitary fibrous tumour of the adrenal gland associated with pregnancy

Solitary fibrous tumour (SFT), first described as a pleural lesion, has bee n reported in several extrathoracic sites over the past 10 years. We descri be a SFT of the left adrenal gland incidentally discovered in a 23-year-old , 22-week pregnant woman and characterised by a rapid growth during the thi rd trimester of pregnancy. Elevated serum and urinary levels of cortisol an d elevated blood levels of delta 4 androstendione and 17-OH progesterone we re observed. After spontaneous delivery, the patient underwent laparoscopic resectioning of the mass and of the left adrenal gland from which the tumo ur was apparently originating. The kidney was not involved, and no other ab dominal rumours were found. Histological and immunohistochemical features w ere typical of SFT of pleura and other locations. Only one case of adrenal SFT is on record, and the adrenal gland is to be added to the long list of extrathoracic locations of SFT. The association with pregnancy was a previo usly unrecognised event in SFT. The focal expression of progesterone recept ors in the tumour cells may be related to pregnancy This observation prompt ed an analysis of steroid hormone receptors in SFT of classical sites (pleu ra). Two of five cases had focal progesterone receptors too, a finding whic h deserves further investigations in a much larger series of SFTs.