Locally recurrent primary adrenal leiomyosarcoma discovered incidentally 7 years after initial surgery: a case report
- Author:
Myungsoo IM
1
;
Doohwa KIM
;
Soree RYANG
;
Bo Hyun KIM
Author Information
- Publication Type:Case report
- From:Kosin Medical Journal 2026;41(1):85-90
- CountryRepublic of Korea
- Language:English
- Abstract: Primary adrenal leiomyosarcoma (PAL) is an aggressive, rare tumor that is frequently diagnosed at an advanced stage. We report the case of a 65-year-old female patient with hypertension who presented with stabbing lower abdominal pain and unintentional weight loss. Abdominal computed tomography (CT) demonstrated a 10.4×8.2×8.1 cm heterogeneous left adrenal mass without biochemical evidence of hormonal hypersecretion. Retroperitoneal left adrenalectomy was performed without complications, and histopathological examination confirmed a moderately differentiated adrenal leiomyosarcoma. The patient was followed at the outpatient oncology clinic for 5 years with no evidence of recurrence. Seven years after the initial surgery, a newly detected left suprarenal mass was identified on imaging. Abdominal CT revealed a new, well-circumscribed 7.1×6.4×6.2 cm heterogeneous mass. Laparoscopic resection of the recurrent mass was performed. Pathological examination again revealed a moderately differentiated leiomyosarcoma with positive surgical margins but no lymphovascular invasion. Immunohistochemical staining was positive for smooth muscle actin, desmin, h-caldesmin, neuron-specific enolase, and synaptophysin, findings consistent with recurrent adrenal leiomyosarcoma. This case demonstrates that PAL can recur locally after prolonged disease-free intervals, underscoring the importance of extended surveillance, potentially beyond 10 years.
