Clinical Features and Outcomes of Adrenal Cavernous Hemangioma: A Study of 8 Cases from a Single Center

Abstract

Background. Cavernous hemangioma is a rare benign tumor that develops from the adrenal glands. In this study, we present our experience with patients with adrenal cavernous hemangiomas (ACH) in a Chinese population. Methods. Demographic, diagnostic, surgical, and pathological findings in patients at a single institution who were adrenalectomized as a result of ACH were retrospectively reviewed. Results. Among 601 patients who underwent adrenalectomy, 8 (1.33%; 5 men, 3 women) cases were diagnosed with ACH between January 1, 1998, and December 31, 2018, in a single institution. The mean age was 53.25 ± 11.9 years (range, 35–67 years). Four (50%) were asymptomatic, and three (37.5%) complained of abdominal or flank discomfort. Preoperative computed tomography (CT) revealed ACH in 3 (37.5%) cases. Well-defined borders and heterogeneous enhancement with characteristic progressive partial filling-in were characteristic CT features of ACH (tumor size>3 cm). The mean tumor size was 5.16 ± 3.4 cm (range, 1.5–11 cm). No recurrence occurred during a median follow-up period of 38.37 months (range, 8–60 months). Conclusions. ACH was asymptomatic in most cases, and diagnosis could be challenging. Adrenalectomy is a safe treatment modality for ACH, and it ensures favorable outcomes.

Rare Case of Adrenal Hemangioma Discovered Incidentally during Renal Colic Investigation

“…A retrospective study conducted at a single institution in China between January 1998 and December 2018 revealed that among the 601 patients who underwent adrenalectomy, only 8 were diagnosed with adrenal cavernous hemangioma [16]. According to this study, there was no evidence of a disease recurrence at the median follow-up interval of 38.37 months (ranging from 8 to 60 months).…”

“…Based on the current reported literature, active surgical treatment is recommended when the tumor diameter exceeds 4 cm. Patients can be closely observed in the case of adrenal hemangiomas smaller than 3.5 cm; however, surgery can be considered if the tumor increases in size [16][17][18][19][20]. Resection can be considered in cases of indeterminate imaging, tumors with mass effect, substantial growth on surveillance, or hemorrhage [21].…”

Clinical Characteristics of Adrenal Hemangioma

“…However, 25% presented with difficult-to-control hypertension or related complications like headaches, palpitations, or hypokalemia. Sudden hypotension from rupture hemorrhage is another rare but potentially fatal presentation [ 3 ].…”

“…Most are cavernous types; capillary and other types are rare [ 1 ]. Since the first reported case in 1955 [ 2 ], approximately 100 cases have been described, but most are case reports or small case series [ 1 , 3 , 4 ], limiting comprehensive understanding of AH clinical characteristics. Preoperative diagnosis is challenging, with pheochromocytoma the most frequent misdiagnosis, resulting in unnecessary preoperative medication.…”