# To Resect or Not to Resect: An Incidental Finding of an Adrenal Schwannoma

## TL;DR

A 61-year-old man had an adrenal schwannoma discovered incidentally during an MRI, leading to its surgical removal due to its large size.

## Contribution

Highlights the importance of resecting large adrenal masses due to increased malignancy risk, even if they appear nonfunctioning.

## Key findings

- A 6 cm adrenal mass was found incidentally during an MRI for gallstones.
- The mass was surgically removed and confirmed to be a schwannoma.
- Larger adrenal masses should be considered for resection due to malignancy risk.

## Abstract

Adrenal masses are commonly classified as adenomas, with other pathologies including pheochromocytomas, adrenocortical carcinoma, and metastasis. Specifically, adrenal schwannomas are an extremely rare form of adrenal tumor. In this report, we present a case of a 61-year-old male patient who underwent an MRI of the abdomen for the evaluation of gallstones and was found to have an incidental left adrenal mass measuring approximately 6 cm. He was referred to urology and endocrinology due to concerns about malignancy. Given the size of the lesion, despite unremarkable adrenal laboratory studies, an interdisciplinary discussion was held in favor of resection. He later underwent adrenalectomy, in which pathology revealed a 6.5 cm schwannoma. It is important for physicians to be aware that at a certain size, consideration must be given to the resection of an adrenal mass due to the increased incidence of malignancy with larger sizes, despite their typical nonfunctioning presentation.