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[Old adrenal hematoma: a case report].

S Yotsuyanagi1, Y Maeda, H Fuse

  • 1Department of Urology, Kouseiren Takaoka Hospital.

Hinyokika Kiyo. Acta Urologica Japonica
|March 10, 2001
PubMed
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A 75-year-old man presented with a left adrenal mass. Imaging and tests were inconclusive, but surgery revealed an old hematoma, not a tumor.

Area of Science:

  • Endocrinology
  • Radiology
  • Pathology

Background:

  • A 75-year-old male patient presented with a left adrenal mass.
  • The patient had a history of arrhythmia and hypertension, treated with warfarin and calcium-antagonists.

Observation:

  • Abdominal ultrasonography identified a 5 cm left adrenal mass.
  • Endocrinological studies showed slightly elevated serum noradrenaline.
  • 131I-MIBG scintigraphy did not reveal radio-isotope uptake in the adrenal gland.

Findings:

  • Computed-tomography (CT) scan demonstrated a left adrenal mass with central low density and peripheral iso-density.
  • Enhanced CT and dynamic MRI revealed enhancement only in the peripheral area of the mass.
  • Histopathological examination confirmed an old hematoma within the adrenal medulla, with no neoplastic cells or vascular lesions.

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Implications:

  • This case highlights the importance of considering adrenal hematoma in the differential diagnosis of adrenal masses.
  • Adrenal hematomas can mimic tumors on imaging, necessitating thorough histopathological evaluation.
  • Accurate diagnosis is crucial for appropriate patient management and avoiding unnecessary treatments for neoplastic conditions.