PT  - JOURNAL ARTICLE
AU  - Rohana Abdul Ghani
AU  - Fatimah Zaherah Mohamed Shah
AU  - Mohammad Hanafiah
AU  - Mardiana Abdul Aziz
TI  - Periadrenal inflammatory myofibroblastic tumour: half a decade before cure
AID  - 10.1136/bcr-2018-225687
DP  - 2019 Feb 01
TA  - BMJ Case Reports
PG  - e225687
VI  - 12
IP  - 2
4099  - http://casereports.bmj.com/content/12/2/e225687.short
4100  - http://casereports.bmj.com/content/12/2/e225687.full
SO  - BMJ Case Reports2019 Feb 01; 12
AB  - A 30-year-old ex-smoker with a background history of childhood asthma presented with worsening shortness of breath despite receiving high doses of oral corticosteroid for pemphigus vulgaris which was diagnosed 5 years earlier. A high-resolution CT examination of the thorax reported non-specific bronchiectatic changes and revealed an incidental suprarenal mass. A subsequent CT scan confirmed a large adrenal mass with areas of necrosis and calcification. Serum renin and aldosterone, urinary catecholamine and 5-hydroxyindoleacetic acid were within normal limits. Surgical intervention was delayed due to difficulty in optimising preoperative respiratory functions. He finally underwent a midline laparotomy for removal of the tumour. Histopathological examinations revealed extrapulmonary inflammatory myofibroblastic tumour arising from the periadrenal soft-tissue, with presence of normal adrenal gland. He showed immediate improvements of his asthmatic symptoms and pemphigus vulgaris following the surgery. His oral steroid was rapidly reduced and he achieved complete remission 2 months later.