Primary Adrenal Squamous Cell Carcinoma in a Single Kidney Patient: Case Report and Review of Literature

The adrenal gland is a common metastatic site of squamous cell carcinoma (SCC), however primary adrenal SCC has not been reported in literature. In this case report, we presented the first case of primary adrenal SCC. A 53-year-old man presented with chronic right flank pain. Abdominopelvic computed tomography (CT) confirmed left kidney agenesis and a soft tissue density mass measuring about 40×30 mm in the right adrenal gland. Adrenal functional assessment including metanephrine, normetanephrine and vanillyl mandelic acid were normal. The patient underwent surgical resection of right adrenal mass. Pathology report revealed adrenal SCC. Immunohistochemistry evaluation demonstrated positive staining for P63, CK, CD10, CK7, chromogranin, neuron specific enolase, and negative staining for alpha-inhibin, neurofilament, CK20, and tyrosine hydroxylase that were compatible with SCC. All other assessments to find primary site of SCC including upper and lower gastro-intestinal endoscopy, chest CT scan, positron emission tomography scan, and bronchoscopy demonstrated normal findings. To our knowledge, this is the first case of primary adrenal SCC without any evidence of metastatic nature of such adrenal involvement by SCC.