A case of primary adrenal microcystic/reticular schwannoma affecting the right adrenal gland in a 31-year-old female was reported. Histologically, the tumor significantly consisted of strikingly anastomosing strands of spindle cells imparting a microcystic and reticular pattern with a focal transition to epithelioid nests. Immunohistochemically, S-100 and CD56 protein showed a uniform and strong positivity, GFAP and EMA weakly and focally expressed, but AE1/AE3, CK5/6, CD31, CD34, calrentin, D2-40, WT1, CgA, Melan-A and Neu-N were negative. The patient live through a calm period for 4 months after the whole right paranephros was removed with no evidence of relapse. This interesting case showed primary adrenal microcystic/reticular schwannoma is characteristic of a distinctive and infrequent morphology compared to another subtype of schwannoma involved in the paranephros. To be familiar with its significant histological features would prompt us to take it into consideration when facing the mimickers.
Keywords: Microcystic/reticular schwannoma; adrenal gland; differential diagnosis; immunohistochemistry; pathology.