330 / 366
Results:
Microscopic examination from the adrenal
’
s tissue fragment
showed partial autolysis details, focal fibrosis, presence of inflammatory
infiltrations, macrophages, hemosiderin granules and congested vessels
with slightly thickened wall. Macroscopic examinations in both tissue
fragments revealed, in an expanded almost universal extent, the presence
of mature adipocytes together with extramedullary hematopoietic details.
There were also observed haemorrhagic infiltrations, phagocytes, hemo-
siderin granules and the local presence of amorphous eosinophilic mate-
rial. All above indicated myelolipoma.
Conclusion:
Adrenal myelolipomas can vary widely in size. They are
characterized as rare tumours with estimated autopsy prevalence of 0.08
to 0.4 %. They are usually indentified in adults, either incidentally or if
complicated by haemorrhage. There is no gender predilection. The tu-
mour affects men and women equally and is most commonly found
between the fifth and seventh decades of life with a mean age of 62 years.
E-PS-07-007
Incidental retroperitoneal mass: Ectopic adrenocortical oncocytoma
I. Saygin
*
, E. Cakir, M. E. Ercin, S. Ersoz
*
Black Sea Technical University, Pathology, Trabzon, Turkey
Objective:
Ectopic adrenocortical adenomas arise from adrenal rests
which are seen through embrionic migration line. Until date 35 cases sited
different anatomical locations described in the literature. Retroperitoneal
location and oncocytic features are extremely rare. We report 56 years old
male presented have a mass in retroperitoneal fat tissue on abdomen
magnetic resonance imaging (MRI). Adrenocortical neoplasms are the
most common tumours of adrenal cortex. Cortical tissue is found either
seperately or with medullary tissue in ectopic adrenal rest. It may undergo
hyperplasia, adenoma or carcinoma; hence surgical resection is necessary
when they were detected.
Method:
The surgical spesimens were formalin-fixed and paraffin embed-
ded. The section were stained with routinary H&E.
Results:
On microscopic examination tumour cells have large eosinophil-
ic granular cytoplasm and small nuclei. They presented nested or solid
pattern that surrounded fibrous capsule. There is no mitosis, necrosis,
cellular atypia, capsular or vascular invasion. Immunohistochemistry
show positive staining with calretinin , synaptophysin , melanA .
Conclusion:
Most oncocytic tumours arise from endocrine organs are
nonfunctional. No association between tumour and adrenal gland or kid-
ney on MRI suggested that the tumour is ectopic located. Adrenal gland
near the tumour capsule and calretinin, synaptophysin, melanA expres-
sions suggested that the tumour originated from adrenal gland.
E-PS-07-008
Adrenocortical carcinoma: A case report
A. Orhan Gokce
*
, E. Dogan, D. Gursoy, I. E. Secinti, T. Ozgur, S.
Hakverdi, S. Görür
*
Mustafa Kemal University, Medical School, Pathology Dept., Hatay,
Turkey
Objective:
Adrenal cortical carcinoma (ACC) is a rare sporadic endo-
crine malignancy with an incidence of 0.7
–
2 cases per million population.
It most commonly occurs between 40 and 50 years of age, with high
morbidity and mortality.
Method:
55-year-old man was previously operated due to left surrenal
mass and diagnosis was Cushing Syndrome. After that he applied with
nausea and vomiting. Computed tomography scan revealed a 9 cm pelvic
mass.
Results:
The surgically resected specimen showed a well-circumscribed,
partially encapsulated tumour measuring 9.0 cm in greatest dimension.
Grossly, the lesion was heterogeneous tan-brown to yellow, hemorrhagic
and necrotic. Microscopic examination revealed sheets and nests of high-
grade pleomorphic tumour cells with abundant clear to vacuolated cytoplasm
with areas of necrosis, a high mitotic index (>10 mitoses/10HPF)
Immunohistochemical stains revealed the tumour cells were positive for
Melan-A, Vimentin, Inhibin and Synaptophysin, NSE, P53(strongly) and
negative for EMA, CK7, CK20. Based upon the morphologic and immuno-
histochemical profile, the diagnosis was adrenocortical carcinoma.
Conclusion:
Adrenocortical carcinoma is a rare but aggressive tumour of
the adrenal with an incidence about 1 in a million. It is slightly more
common in females. Surgery remains the mainstay treatment for localized
disease, but it is often not feasible in more advanced cases.
E-PS-08-001
Leiomyosarcoma of lower third of the rectum: Case report of an
uncommon neoplasm
I. Glavynskyi
*
, M. Yanovytskaya, L. Zakhartseva, M. Dyatel, O. Guz
*
Kiev City Oncology Center, Dept. of Pathology, Ukraine
Objective:
Leiomyosarcoma of the rectum is a rare entity that comprises
less than 0.1 % of all rectal malignancies. Because of its rarity, its diag-
nosis and treatment often present challenges.
Method:
A 46-year-old Caucasian woman with a long history of hemor-
rhoids that arose after childbirth, turned to a routine examination to the
proctologist. During the rectosigmoscopy, a submucosal formation with a
diameter of 1 cm was detected. Because of extreme similarity with
submucous leiomyoma, a decision was made in favor of a wide excision
of the nodule.
Results:
Tumour consists of interlacing spindle-shaped cells, with a
marked cellular pleomorphism, with large and hyperchromatic nucleus,
and abundant eosinophilic cytoplasm. Mitotic figures (16 per 10 HPF)
and atypical mitotic figures were also noted. Immunohistochemistry re-
vealed that neoplastic cells expressed desmin, smooth muscle actin, and
exhibited negative staining for CD117, CD34, S-100, Cytokeratin pan,
Synaptophysin, Chromogranin, HMB-45. Ki-67(MIB-1) was 35 %.
Subsequently, a diagnosis of grade II leiomyosarcoma was retained.
Conclusion:
Leiomyosarcoma of the rectum is a life-threatening
diagnosis that should not be underestimated because of the high
risk of local recurrence and hematogenous metastases. Our patient
today has 17 months of relapse-free survival. Follow-up monitor-
ing will be conducted.
E-PS-08-002
Recurrent rectal heterotopic gastric mucosa in a child patient
M. Trujillo Coronado
*
, G. Sosa Rotundo, M. A. Cabezas-Quintario, A. L.
Valencia Mesa, L. López Brasal, F. J. Pinedo Moraleda
*
Hospital Fundacion Alcorcon, Pathology, Madrid, Spain
Objective:
To review recurrent rectal heterotopic gastric mucosa in a
child patient.
Method:
Heterotopia is a condition in which normal tissue is abnormally
located in a distinct anatomical site. Heterotopic gastric mucosa (HGM) is
rare, having been identified throughout the gastrointestinal tract, more
frequently in oesophagus and duodenum, being unusual in the rectum
(78 cases reported since 1939, 32 in patients under 16 years old).
Results:
Typically, HGM is asymptomatic, nevertheless, when symptom-
atic, it can present rectal bleeding, stricture formation, or obstruction,
being the reason why differential diagnosis with rectal ulcers, gastroin-
testinal infestations, congenital malformations or inflammatory bowel
diseases should be included. The definitive diagnosis of HGM requires
E-PS-08 Digestive Diseases Pathology - GI
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S316