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[Idiopathic adrenal hemorrhage: a case report]
T Sakamoto1, H Azuma, Y Iwamoto
1Department of the Urology, Osaka Medical College.
Hinyokika Kiyo. Acta Urologica Japonica
|January 20, 1999
Summary
A persistent fever led to the discovery of an adrenal mass. Idiopathic adrenal hemorrhage was diagnosed after surgical removal, ruling out malignancy.
Area of Science:
- Endocrinology
- Radiology
- Surgical Pathology
Background:
- Adrenal masses can present with diverse clinical and imaging findings.
- Distinguishing between adrenal tumors and other adrenal pathologies is crucial for appropriate management.
Observation:
- A 77-year-old male presented with a 30-day low-grade fever and an abdominal computed tomographic scan revealed a left adrenal gland mass.
- Hormonal assays showed slightly elevated noradrenaline and vanillylmandelic acid levels.
- Magnetic resonance imaging and angiography depicted a heterogeneous, hypovascular supra-renal mass.
Findings:
- Surgical resection (adrenalectomy and nephrectomy) was performed due to severe adhesions.
- Histopathological examination confirmed the mass was a hematoma, not a malignant tumor.
- The final diagnosis was idiopathic adrenal hemorrhage.
Implications:
- This case highlights the importance of considering non-neoplastic causes, such as adrenal hemorrhage, in the differential diagnosis of adrenal masses.
- Accurate histopathological evaluation is essential for definitive diagnosis and guiding patient treatment.
- Idiopathic adrenal hemorrhage can mimic adrenal tumors clinically and radiologically.