Rare cavernous hemangioma of adrenal gland: case report

Abstract

CONTEXT: Cavernous hemangiomas of the adrenal gland are rare benign neoplastic tumors. The clinical presentation of adrenal hemangiomas is usually vague, and they are often discovered incidentally through imaging examinations performed for other reasons. CASE REPORT: We report the case of a non-functional adrenal hemangioma found incidentally in a 37-year-old man with a one-year history of headache and hypertension. A right adrenal mass was detected by means of magnetic resonance imaging. Physical examination and all laboratory values were unremarkable. The patient underwent laparoscopic right adrenal gland resection. Histopathological evaluation confirmed adrenal cavernous hemangioma. CONCLUSIONS: Most occurrences of cavernous hemangiomas of the adrenal gland are non-functional and often discovered incidentally. Although rare, these unusual benign adrenal masses should form part of the differential diagnosis of adrenal neoplasms. The proper treatment for adrenal cavernous hemangioma is surgical removal. RESUMO CONTEXTO:Hemangiomas cavernosos da glândula adrenal são tumores neoplásicos raros, benignos. A apresentação clínica dos hemangiomas adrenais é geralmente vaga e muitas vezes eles são descobertos acidentalmente por exame imagiológico realizado por outras razões. RELATO DE CASO: Nós relatamos um caso de hemangioma adrenal não funcional encontrado por acaso em um homem de 37 anos de idade com histórico de um ano de dor de cabeça e hipertensão. Foi detectada massa adrenal direita por meio de ressonância magnética. Exame físico e todos os valores de laboratoriais estavam normais. O paciente foi submetido a cirurgia laparoscópica para ressecção da glândula adrenal direita. Avaliação histopatológica confirmou hemangioma adrenal cavernoso. CONCLUSÃO: A maioria dos hemangiomas cavernosos de glândula adrenal são não funcionais e muitas vezes descobertos por acaso. Embora raras, essas massas adrenais benignas devem ser parte de um diagnóstico diferencial de neoplasias suprarrenais. O tratamento adequado para o hemangioma adrenal cavernoso é a remoção cirúrgica. IMSc. Postgraduate Student,

Benign vascular tumors, cysts, and pseudocysts of the adrenal gland: a contemporary multi-institutional clinicopathological analysis of 55 cases

“…To date, there are only a few case series and case reports on benign adrenal vascular tumors, cysts and pseudocysts [1][2][3][4][5][6][7][8][9][10][11][12][13]. In reported case cohorts, the emphasis had focused on differential diagnosis of benign adrenal vascular lesions versus epithelial neoplasms in a setting of cystic lesions or hemorrhagic lesions of the adrenal gland [3,[5][6][7].…”

Giant Adrenal Cavernous Hemangioma in a Patient with Familial Adenomatous Polyposis

“…AH are often discovered as incidentalomas either by imaging studies or histologic examination. 1 , 9 They are usually unilateral and are more frequent in women in the 5th or 7th decade. 6 , 7 , 9 AH are usually asymptomatic but can be revealed by a painful palpable mass or by retroperitoneal hemorrhage.…”

“…The diagnosis is often made by abdominal or pelvic CT scan, showing an hypodense, heterogenous mass with variable areas of hemorrhage or necrosis. 6 , 7 , 9 Calcifications are noted in approximately two-thirds of cases but they are not specific since they may be observed in a variety of other adrenal lesions, including pheochromocytoma, hemorrhage, tuberculosis, adrenal cortical carcinoma, gastrointestinal metastasis and melanomas. 7 , 9 , 10 Magnetic resonance imaging (MRI) is proven to be a valuable diagnostic tool for AH.…”

“…In the skin, the brain or the liver, they are usually congenital and hereditary factors seems to play a role. 9 Furthermore, cavernous hemangioma may integrate a congenital syndrome such as, Rendu Osler Weber disease, Von Hippel Lindau disease or Sturge-Weber syndrome. For the adrenal location, there is no evidence of an hereditary origin since all the published cases were sporadic and were not the subject of any genetic study.…”

Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas

“…They are generally asymptomatic. When present, symptoms are typically related to tumor volume [72,76], although functioning hemangiomas have been reported [77]. Hemorrhage can also occur, sometimes life threatening [78].…”