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[Spontaneous unilateral adrenal hematomas. 10 cases]
Presse Medicale (Paris, France : 1983)
|June 11, 1994
Summary
Spontaneous unilateral adrenal hematomas are rare, often presenting as large adrenal masses. Magnetic resonance imaging (MRI) is crucial for diagnosis, distinguishing hematomas from other adrenal conditions.
Area of Science:
- Radiology
- Endocrinology
- Pathology
Background:
- Spontaneous unilateral adrenal hematoma is an exceptionally rare clinical entity.
- Diagnosis is challenging due to the absence of specific clinical signs or functional disorders.
Observation:
- Computed tomography (CT) typically shows large adrenal masses (>4 cm) with non-specific soft-tissue attenuation.
- Magnetic resonance imaging (MRI) offers diagnostic clues, revealing T1-weighted hyperintense foci and T2-weighted heterogeneous masses, often with absent enhancement post-Gd-DTPA.
Findings:
- Pathological examination confirmed idiopathic hematoma in 5 cases and hematoma associated with a small benign tumor in 5 cases.
- MRI with dynamic perfusion studies is key in suggesting the diagnosis.
Implications:
- Adrenal hematoma should be considered in asymptomatic patients with incidentally discovered large, unilateral adrenal masses.
- Waiting and repeat imaging, guided by MRI findings, can help avoid unnecessary surgery.