Adrenal Cavernous Hemangioma: A Rarely Perceived Pathology—Case Illustration and Review of Literature

Abstract

Cavernous hemangiomas are endothelial tumors that rarely affect the adrenal glands. Most of these tumors remain silent and are incidentally found on abdominal imaging. Hardly ever, these tumors are endocrinologically functional. They may present as vague abdominal pain. Surgical resection remains the mainstay for large masses. In this paper, we are presenting a case of adrenal cavernous hemangioma in a 83-year-old male patient who initially presented for workup of vague abdominal and bilateral flank pain. A computed tomography scan of the abdomen showed an 8 cm right adrenal adenoma which was metabolically nonfunctional. The mass was completely resected through an open subcostal incision, with no encountered postoperative complications. A highlight of all published cases of adrenal hemangiomas since 1955 is also presented and reviewed.

Adrenal cavernous Hemangioma;A rare diagnosis of adrenal incidentaloma:A case report, and literature review

“…While some reports suggest that adrenal cavernous hemangiomas tend to appear hypointense on T1-weighted MRI, 2 Noh et al review found no strong clinical evidence to back this suggestion. Because of the large amount of blood contained inside the mass, the majority of the cases were hyperintense on T2-weighted MRI.…”

“…This can explain the findings of Degheiliet al Review in which only 6 of the 66 reviewed cases were hormonally active. 2 Moreover, Noh et al proposed that the cause of hormonal activity in those cases is not hypersecreting tumor cells, but the arteriovenous malformations within the lesions that facilitate the entry of hormonally active metabolites into the bloodstream. 3…”

“…Other presenting symptoms including retroperitoneal bleeding and hyperaldosteronism were infrequently reported. 2 …”

“…However, other indications including mass effect symptoms have been also reported. 2 On the other side, when the tumor is small and is not associated with a hormonal disturbance, active surveillance with endocrinological and radiological evaluation may be considered. 3…”

“…Hence, it is managed by surgical resection in most cases and the diagnosis of hemangioma is often made post-operatively. 2 …”