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Rare Case of Adrenal Hemangioma Discovered Incidentally during Renal Colic Investigation.
Almajed, Ebtesam H; Alshamrani, Abdullah M; Alqahtani, Adel S; Alzahrani, Abdulrahman J; Alahmadi, Thamer; Asiri, Shuaa M.
Afiliação
  • Almajed EH; Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
  • Alshamrani AM; Department of General Surgery, Security Forces Hospital, Riyadh, Saudi Arabia.
  • Alqahtani AS; Department of General Surgery, Security Forces Hospital, Riyadh, Saudi Arabia.
  • Alzahrani AJ; Department of General Surgery, Security Forces Hospital, Riyadh, Saudi Arabia.
  • Alahmadi T; Department of General Surgery, Security Forces Hospital, Riyadh, Saudi Arabia.
  • Asiri SM; Department of Pathology, Security Forces Hospital, Riyadh, Saudi Arabia.
Am J Case Rep ; 25: e943826, 2024 Jul 05.
Article em En | MEDLINE | ID: mdl-38965761
ABSTRACT
BACKGROUND Hemangiomas of the adrenal gland are rare benign non-functional tumors arising from the gland's vascular endothelium. Adrenal hemangiomas are rare in clinical settings, often discovered incidentally during an unrelated diagnostic investigation. CASE REPORT A 39-year-old man presented with a heterogeneous, enhancing 4.56×4.24×3.9-cm mass originating from the right adrenal gland's lateral limb, discovered incidentally on computed tomography (CT) to investigate renal colic. He was routinely followed up for 2 years with serial CT scans; the mass exhibited considerable growth compared with baseline, with a relatively stable appearance with hyperdense soft tissue component, fat, and foci of calcification. Dexamethasone suppression test demonstrated suppressed cortisol response, indicating a non-functional mass. Therefore, laparoscopic right adrenalectomy was performed, owing to the benign nature of the preoperative diagnosis of myelolipoma and mass size. The patient experienced an uneventful recovery, with no perioperative complications. The resected mass was 5×4×4 cm in size and weighed 30 g. Histopathology confirmed adrenal hemangioma. Serial sectioning revealed an encapsulated lesion with heterogeneous solid and cystic surfaces. Light microscopy examination showed dilated and congested vascular channels lined by flattened endothelium. Focal mature adipose tissue was seen. CONCLUSIONS The infrequent occurrence of adrenal hemangiomas and their nonspecific clinical and radiological presentation results in a considerable diagnostic challenge and, often, misdiagnosis. Surgical resection is usually necessary to exclude malignant disease, alleviate pressure-related symptoms, and decrease risk of retroperitoneum hemorrhage. These lesions are associated with a good prognosis. One limitation of this report is the lack of preoperative adrenal magnetic resonance imaging of the incidental adrenal mass.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias das Glândulas Suprarrenais / Adrenalectomia / Achados Incidentais / Cólica Renal / Hemangioma Limite: Adult / Humans / Male Idioma: En Revista: Am J Case Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Arábia Saudita

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias das Glândulas Suprarrenais / Adrenalectomia / Achados Incidentais / Cólica Renal / Hemangioma Limite: Adult / Humans / Male Idioma: En Revista: Am J Case Rep Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Arábia Saudita