Recurrent fever leading to the diagnosis of an angiosarcoma of the adrenal gland: a case report

TL;DR

A rare adrenal gland angiosarcoma was diagnosed in a 46-year-old man after he experienced persistent fevers and weight loss.

Contribution

This case report highlights the importance of considering angiosarcoma in the differential diagnosis of adrenal tumors.

Findings

The patient presented with a 12 cm adrenal tumor and symptoms of fever and weight loss.

Histological analysis confirmed the diagnosis of angiosarcoma of the adrenal gland.

The case emphasizes the need for interdisciplinary treatment and sharing of clinical experiences for rare tumors.

Abstract

Angiosarcoma of the adrenal gland is a very rare malignant vascular neoplasm. The clinical symptoms are atypical or completely absent. Angiosarcomas of the adrenal gland are therefore often discovered incidentally, and the diagnosis is made histologically after resection.

A 46-year-old white Spanish male who was a previous smoker and nondrinker and was slightly overweight (92 kg, 176 cm, body mass index 29.7 kg/m2) with no relevant medical history presented to the internal medicine emergency department of our hospital with an unclear 12 cm tumor of the right adrenal gland. Prior to the computed tomography scan, he had had persistent evening fevers for 4 months and unintentional weight loss of 5 kg. The laboratory results showed anemia and an elevated C-reactive protein, but no hormone production. We performed an open adrenalectomy of the right adrenal gland. Finally, the histologic findings revealed an angiosarcoma of the adrenal gland.

Even though angiosarcomas of the adrenal gland are rare, the differential diagnosis of an angiosarcoma should be considered if a malignant tumor of the adrenal gland is suspected. Treatment decisions should be made on an interdisciplinary basis and preferably in a specialized center. Owing to the rarity of angiosarcomas of the adrenal gland, it is necessary to continue to share clinical experience to gain a better understanding of this particular tumor entity.

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