Teratoma in the region of adrenal gland: A unique entity masquerading as lipomatous adrenal tumor

Background. The aim of this study was to establish the clinical and pathologic aspects of 3 atypical lipomatous lesions in the region of the adrenal gland. Methods. Three young Chinese patients (ages 18, 18, and 37 years) were seen for nonspecific back pain. Radiologic examination revealed a lipomatous lesion in the region of the adrenal gland, and hormonal assessment was normal. Calcification was noted in 2 of the 3 lesions. Adrenalectomy was performed because of the size (diameter 7.5, 10, 11 cm) of the tumors with suspected local symptoms. Results. On gross examination 2 tumors were cystic and 1 was solid. In all 3 patients the diagnosis was mature teratomas. The tumors were composed of mature tissues arising from more than 1 germinal layer. There was no evidence of immature elements or malignancy. Adipose tissue was the predominant component in the tumors. There was no evidence of recurrent diseases in all these patients during follow-up. Conclusions. To our knowledge, this is the first report of teratomas occurring in the adrenal region. Teratoma should clinically and radiologically be included in the differential diagnoses of lipomatous adrenal lesions. Excision of the teratoma is advocated.