Adrenal Schwannoma: A Rare but Important Consideration in Adrenal Tumors

Adrenal schwannomas (AS) are rare and are often detected incidentally on imaging studies. Due to their nonspecific imaging characteristics and typically normal endocrine profiles, definitive diagnosis relies on histopathological examination. This case report presents a 72-year-old male patient with a 4.6 cm right adrenal mass, initially suspected to be an adrenal adenoma on ultrasound. A contrast-enhanced computed tomography (CT) scan later characterized the lesion as a well-defined, heterogeneous, loculated mass with an absolute washout of 40% and a relative washout of 18.2%, raising concerns about its malignant potential. Endocrine evaluation confirmed its nonfunctional nature. Given its increasing size and unclear nature, surgical excision via robot-assisted transperitoneal adrenalectomy was performed. Histopathological and immunohistochemical analyses confirmed the diagnosis of a benign adrenal schwannoma. This case highlights the diagnostic challenges and therapeutic approach to AS, emphasizing the role of surgical resection in managing adrenal incidentalomas with indeterminate malignant potential.