{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:51:29Z","timestamp":1761745889148,"version":"build-2065373602"},"reference-count":54,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,14]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Primary adrenal leiomyosarcoma is an extremely rare soft tissue tumour arising from the smooth muscle of adrenal vascular structures, with approximately 50 reported cases worldwide. The tumour typically presents with non-specific symptoms and does not produce hormones, often leading to a delayed diagnosis. It is usually identified on CT or MRI, but definitive diagnosis requires histopathology and immunohistochemistry. We describe the case of a young woman in her early 30s who presented with epigastric and left flank pain and was subsequently found to have a large adrenal mass. She underwent surgical resection and remains recurrence-free 13 months postsurgery.<\/jats:p>","DOI":"10.1136\/bcr-2025-266476","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T10:11:01Z","timestamp":1761732661000},"page":"e266476","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Primary adrenal leiomyosarcoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-2709","authenticated-orcid":false,"given":"Syed Muhammad","family":"Nazim","sequence":"first","affiliation":[{"name":"Surgery (Urology Section), The Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Hummam","family":"Siddique","sequence":"additional","affiliation":[{"name":"Surgery, The Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7129-5665","authenticated-orcid":false,"given":"Imran Khan","family":"Jalbani","sequence":"additional","affiliation":[{"name":"Surgery, The Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayesha","family":"Nusrat","sequence":"additional","affiliation":[{"name":"Pathology, The Aga Khan University Hospital, Karachi, Sindh, Pakistan"},{"name":"Pathology, Ziauddin Medical University, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"2025102903101304000_18.10.e266476.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12902-023-01530-z","article-title":"Challenges in the diagnosis of the enigmatic primary adrenal leiomyosarcoma: two case reports and review of the literature","volume":"23","author":"Suzuki","year":"2023","journal-title":"BMC Endocr Disord"},{"key":"2025102903101304000_18.10.e266476.2","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.radcr.2022.11.034","article-title":"Primary adrenal leiomyosarcoma","volume":"18","author":"Waack","year":"2023","journal-title":"Radiol Case Rep"},{"key":"2025102903101304000_18.10.e266476.3","first-page":"317","article-title":"Primary adrenal leiomyosarcoma: A case report","volume":"12","author":"Sakellariou","year":"2020","journal-title":"Mol Clin Oncol"},{"key":"2025102903101304000_18.10.e266476.4","doi-asserted-by":"crossref","first-page":"103955","DOI":"10.1016\/j.critrevonc.2023.103955","article-title":"The biology and treatment of leiomyosarcomas","volume":"184","author":"Kerrison","year":"2023","journal-title":"Crit Rev Oncol Hematol"},{"key":"2025102903101304000_18.10.e266476.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2003.07.007"},{"key":"2025102903101304000_18.10.e266476.6","first-page":"1164","article-title":"Primary adrenal leiomyosarcoma in a man with acquired immunodeficiency syndrome (AIDS). 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