Primary Adrenal Leiomyosarcoma: A Rare and Unusual Cause of a Flank Mass

Leiomyosarcoma (LMS) is a very rare malignant mesenchymal tumour of the adrenal gland that originates from the smooth muscle cells of the central adrenal vein and/or its branches. The tumour has an equal incidence in both males and females. The presentation and diagnosis of LMS in the adrenal gland are usually late and are associated with a poor prognosis. Typically, patients do not present with any specific laboratory or radiological findings; rather, only compressive effects on adjacent structures are noted. Fewer than 50 cases of LMS of the adrenal gland have been reported in the scientific literature. In this case report, a 40-year-old male patient presented with complaints of intermittent right loin pain for one year. Computed Tomography (CT) of the abdomen and pelvis revealed a mass measuring 10.1×8.9×9.6 cm in the right suprarenal region. A right adrenalectomy was performed and histopathological analysis along with the Immunohistochemistry (IHC) profile confirmed the diagnosis of primary adrenal LMS.