Korean J Radiol.  2014 Apr;15(2):245-249. 10.3348/kjr.2014.15.2.245.

Myxoid Adrenocortical Adenoma: Magnetic Resonance Imaging and Pathology Correlation

• Kim TU
• Kim S
• Lee JW
• Lee NK
• Ha HK
• Park WY

• KMID: 1705579
• DOI: http://doi.org/10.3348/kjr.2014.15.2.245

Abstract

We report a case of a 74-year-old female with myxoid adrenocortical adenoma which showed different magnetic resonance imaging findings compared to those of a typical adrenocortical adenoma. The myxoid change in the adrenocortical adenoma is a rare form of degeneration. It presents a considerable diagnostic challenge to both radiologists and clinicians because it can mimic other adrenal tumor types on imaging. The MRI findings of the presented case included a high signal intensity on T2-weighted images similar to that of fluid and delayed progressive enhancement.

Keyword

Adrenocortical adenoma; Myxoid; MRI

MeSH Terms

Adenoma/*diagnosis/pathology
Adrenal Gland Neoplasms/*diagnosis/pathology
Adrenocortical Adenoma/*diagnosis/pathology
Aged
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging
Rare Diseases/*diagnosis/pathology

Figure

• 

  Fig. 1 MR and pathologic findings of myxoid adrenocortical adenoma in 74-year-old woman. A. Axial T2-weighted MR imaging shows high signal intensity similar to that of fluid in tumor. B, C. Axial in-phase (B) and out-of-phase (C) gradient-echo T1-weighted images demonstrate lack of signal intensity loss on out-of-phase images compared with in-phase images in tumor. D, E. Enhancement pattern of tumor on T1-weighted volumetric interpolated breath-hold examination sequence in arterial (D) and delayed phases (E) represents early heterogeneous enhancement and progressive filling. F. Axial diffusion-weighted imaging (b = 1000 s/mm2) demonstrates high signal intensity in adrenal mass. G. Axial ADC map helps to confirm presence of T2 shine-through, showing high signal intensity in adrenal mass. H. On cut section of gross specimen, tumor shows well-circumscribed, yellow-greenish and glistening myxoid appearance. I. Lower magnification of photomicrograph (hematoxylin-eosin stain; original magnification × 40) shows tumor cells arranged in cords and tubules with large amounts of extra-cellular myxoid material.

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