Is adrenal ovarian thecal metaplasia a misnomer? Report of three cases of radial scar-like spindle cell myofibroblastic nodule of the adrenal gland

Endocr Pathol. 2011 Dec;22(4):222-5. doi: 10.1007/s12022-011-9175-6.

Abstract

Ovarian thecal metaplasia is a rare tumor-like mesenchymal lesion of the adrenal gland that has been reported mainly in postmenopausal women and rarely in men. It was originally described as a wedge-shaped lesion composed of ovarian-like stroma resembling theca that shows continuity with the capsule of the adrenal gland. We report three cases and identify that these lesions can resemble a radial scar. While a single case has been reported to contain true ovarian stromal elements, there was no evidence of steroidogenic differentiation in our cases. These findings justify the need for a better terminology since the entity falls within the spectrum of fibroblastic-myofibroblastic proliferations. We propose the terminology of "radial scar-like spindle cell myofibroblastic nodule of the adrenal gland" as a more accurate nomenclature to designate these lesions. Although rare, calcifying fibrous tumor of the adrenal gland, hypertrophic nerve bundles, and peripheral nerve sheath tumors may mimic these lesions.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / pathology*
  • Adrenal Gland Neoplasms / surgery
  • Aged
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Myofibroblasts / pathology*
  • Terminology as Topic