Calcified adrenal masses

We reviewed 106 cases of adrenal masses of all types in all age groups. Thirty-three contained calcium visible on radiographs, sonography, or computed tomography (CT). Neuroblastoma was the most common calcified adrenal mass (10 cases), and occurred only in children. Adrenal cyst (6 cases) was the most common calcified adrenal mass in adults. Other calcified adrenal masses included 5 cortical adenomas, 4 adrenal carcinomas, 3 cases of adrenal hemorrhage, 2 adrenal metastases, 2 pheochromocytomas, and 1 histoplasmoma. Calcification within an adrenal mass is therefore nonspecific. All the adrenal cysts had a characteristic radiographic pattern, showing only peripheral curvilinear calcification. The presence and pattern of calcium in an adrenal mass must be correlated with other imaging features (e.g., size, homogeneity, enhancement pattern, margination) to allow correct differential diagnosis. This can best be done by CT.