Idiopathic Adrenal Hematoma Masquerading as Neoplasm

Abstract

We report herein a case of idiopathic adrenal hematoma. A 59-year-old Japanese man was referred to our hospital for evaluation of a 7.0 cm mass in the right upper abdominal cavity. The tumor was suspected to originate from either the posterior segment of the liver or the right adrenal gland. His chief complaint was weight loss of 8 kg over the previous 6 months. He had no past medical history and took no medications, including no anticoagulants. Laboratory data were almost normal except for a slight elevation of PIVKA-II. The origin of the tumor was found to be the adrenal gland, as angiography revealed the blood supply to the mass to derive from the right superior and inferior adrenal arteries. A fine needle biopsy of the lesion was unable to confirm the diagnosis. Open right adrenalectomy was performed. The histopathological findings of the surgical specimen revealed a hematoma with normal adrenal tissue. In the absence of any obvious etiology, the diagnosis was idiopathic adrenal hematoma.

A Huge Adrenal Hematoma in an Adrenal Cavernous Hemangioma Manifesting as a Chronic Expanding Hematoma of the Retroperitoneum: A Case Report

“…This pattern of peripheral spotty contrast enhancement with centripetal enhancement is crucial for diagnosing adrenal hemangioma and these features were found in the current case. However, the differential diagnosis of an adrenal heman-gioma from other neoplasms, such as adrenocortical adenoma and malignant tumors is difficult 10) . Therefore, a precise preoperative diagnosis is often impossible to make, even though the adrenal hemangioma shows some characteristic radiological findings.…”