Adrenal Leiomyoma Mimicking Adrenal Malignancy: Diagnostic Challenges and Review of Literature
Bibliographic record
Abstract
Leiomyoma arising from adrenals are extremely rare with less than 20 cases reported in medical literature. Leiomyomas, though benign lesions, may frequently be confused with a malignancy, both clinically and on imaging studies, especially when they occur at atypical sites like the adrenals. We present a 42-year-old lady with cachetic symptoms, abdominal swelling and dragging sensation for 6 months, having a 10 cm diameter non-tender firm palpable abdominal mass, which on computed tomography was diagnosed to be a 12.2 × 10.3 × 8.0 cm heterogeneously enhancing adrenal mass having absolute and relative contrast washout values suggestive of malignancy. The tumor was hormonally inactive. Left adrenalectomy was done. Resected specimen weighed 91 g measuring 12 × 10 × 8.0 cm. Histopathology revealed a well-circumscribed and encapsulated benign spindle cell arranged in fascicles and whorls confirming leiomyoma. In the last evaluation 6 months after surgery, there was no evidence of tumor recurrence. This is the largest adrenal leiomyoma ever reported. Leiomyomas have a varied age of presentation (2 - 72 years, median: 38) with female preponderance. They are usually unilateral and hormonally inactive. Human immunodeficiency virus and Epstein-Barr virus infections have been observed in 44.44% and 16.67% of cases respectively. However, direct link between immunodeficiency and adrenal leiomyoma has not been established. Adrenal leiomyoma can present as huge abdominal masses clinically mimicking malignancy, and radiologic investigations can also be misleading. Adrenal leiomyoma should always be considered in the differential diagnosis of huge unilateral non-functional incidentally detected adrenal lesions. J Endocrinol Metab. 2015;5(5):304-308 doi: http://dx.doi.org/10.14740/jem318w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".