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Updated: Jul 7, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
[An adrenal incidentaloma in a trauma patient; a plea for expectant management]
H L van Westreenen1, G A Patijn, E S Sijbrandij
1Isala klinieken, Postbus 10.400, 8000 GK Zwolle. h.l.van.westreenen@isala.nl
Abstract:
An adrenal incidentaloma was detected in 45-year-old female driver after a car-versus-car collision. The mass, which had a diameter of 5.4 cm, was not a hormone-producing tumour, but because of its size laparoscopic adrenalectomy was performed 2 months later. Pathology examination revealed an old haematoma situated centrally in the right adrenal gland. Posttraumatic adrenal haematoma is found in 25% of autopsies of traumatized patients. Most adrenal haematomas have an ovoid appearance on CT and have a slight hyperattenuation. Follow-up CT of an adrenal haematoma shows a decrease in size and attenuation. It is therefore proposed that adrenal incidentalomas detected during trauma screening should be evaluated by repeating CT after 3 months. If the mass has diminished and its density decreased, it is most probably an adrenal haematoma, in which case unnecessary surgery may be avoided.
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