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Hy (ct) scan showed a 6. 3 cmã—6 cm solid mass of the right adrenal gland (figure 1). Figure 1 computed tomography (ct) scan showed a 6. 3 cmã—6 cm solid mass of the right adrenal gland (see arrow) ã€€ã€€there was an indication for surgery,involving an unclear adrenal tumour without hormone production with a significant size. The patient underwent a successful laparoscopic procedure with en bloc removal of adrenal gland. buy viagra online overnight shipping generic viagra viagra without a doctor prescription buy viagra online cheap viagra cheap generic viagra viagra online buy viagra buy viagra online cheap viagra The patient did not request parenteral narcotics but only analgesic post operatively,the post operatory course was uneventful. ã€€ã€€postoperative pathologic evaluation revealed a solitary adrenal tumour measuring 7 cmã—3. 5 cmã—3 cm that was grossly impinging adrenal parenchyma. Histologically,the tumour exhibited morphologic features of typical of a conventional schwannoma (figure 2),the neoplastic cells were spindle shaped with cytological blood nuclei. Immunohistochemical analysis revealed cells that were uniformly s-100 positive,and were negative for actine,ml,ms and cd34. The tumour showed less than 1% immunoreactivity for ki-67 (figure 3a,3b,3c). ã€€ã€€these findings were consistent with a diagnosis of benign schwannoma. Furthermore,adrenal tissue was found in the specimen,which suggested that tumour had an adrenal gland origin. Figure 2 histological preparation with staining for ematossilin-eosine (magnification 20ã—) showing neoplastic cells with spindle shaped and cytological blood nuclei figure 3 (a)immunohistochemical analysis revealed cells that were uniformly s-100 positive (magnification 20ã—) (b)immunohistochemical analysis revealed cells negative for actine (magnification 10ã—) (c)immunohistochemical analysis revealed cells less than 1% immunoreactivity for ki-67(magnification 40ã—) discussion recent increases in the availability and capability of radiological diagnostic technologies have increased the number of adrenal tumours that are incidentally discovered in patients that underwent medical examinations by ultrasonography,computed tomography and mri. ã€€ã€€diagnostic evaluation of identified adrenal masses is required determining whether the lesions are hormonally functioning or non-functioning and malignant or benignï¼»11ï¼½. ã€€ã€€about 85% of incidentally discovered masses are non functional lesions,9% are defined as sub-clinical cushing's syndrome,4% are pheochromocytomas,and only 1% of them are aldosteronomasï¼»11ï¼½. A schawnomma arising from adrenal gland is a very rare entity that has been reported in literature in 10 cases,7 case in the english literature a.
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