RESUMO
OBJECTIVE: To report a case of GIST type retroperitoneal tumor with spontaneous rupture to the abdominal cavity causing acute abdomen secondary to hemoperitoneum. METHODS/RESULTS: We report the case of an 84 year-old man with history of BPH and chronic atrial fibrillation. He presented to the Emergency Department with diffuse abdominal pain, syncope and accompanying vegetative symptoms. Diagnostic work up showed a 19 cm retroperitoneal mass dependent of the left kidney with active bleeding and secondary hemoperitoneum. Left radical nephrectomy was performed with pathology report of gastrointestinal stromal tumor attached to the renal capsule. CONCLUSIONS: Spontaneous hemoperitoneum is a rare entity and it has various etiologies. It is rarely described in retroperitoneal tumors.
Assuntos
Tumores do Estroma Gastrointestinal/complicações , Hemoperitônio/etiologia , Neoplasias Renais/complicações , Neoplasias Retroperitoneais/complicações , Idoso de 80 Anos ou mais , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/cirurgia , Hemoperitônio/terapia , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Masculino , Radiografia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Ruptura EspontâneaRESUMO
OBJECTIVE: To describe a case of adrenal cavernous hemangioma in a 67 year old man who presented left lumbar pain. METHODS: Abdominal ultrasound, contrast enhanced ultrasound of the lesion, abdominal-pelvic CT scan, and then left adrenalectomy and pathology were performed RESULTS: Imaging studies showed a large solid-cystic mass with 12 × 11 cm diameters in the left adrenal gland, well defined, with calcifications, which showed peripheral arterial globular contrast enhancement on CT and ultrasound. The lesion displaced neighboring structures without other findings in the abdominopelvic study. The pathology report after adrenalectomy was: cavernous hemangioma with calcifications, ossifications and necrosis. CONCLUSIONS: Cavernous hemangioma is a rare cause of adrenal mass. The globular peripheral contrast uptake and gradual filling of the lesion on dynamic imaging studies (Ultrasound or CT) and phlebolith type calcifications suggest the diagnosis of typical angioma. However, the presence of thrombosis, necrosis and calcifications in large lesions confer an unusual dynamic behavior and force pathology for definitive diagnosis.