[Old adrenal hematoma: a case report]

A 75-year-old man was admitted to our hospital for closer examination of a left mass. Warfarin and calcium-antagonist for arrhythmia and hypertension had been administered for about 2 months before admission to our ward. Abdominal ultrasonography revealed a left adrenal mass 5 cm in diameter. Only serum noradrenalin was slightly elevated in endocrinological studies. In 131I-MIBG scintigraphy, uptake of radio-isotope at the adrenal gland was not revealed. Computed-tomographic (CT) scan showed left adrenal mass with a low density in the central area and iso-density in the peripheral area. The enhanced CT scan revealed enhancement in only the peripheral area of the left adrenal gland. Magnetic resonance imaging (MRI) showed a different intensity in the central area or peripheral area. Only the peripheral area of the mass was enhanced on dynamic MRI. Left adrenalectomy was performed. Histopathological examination revealed an old hematoma in the adrenal medulla without neoplasmic cells or vascular lesions.