ECE2009 Poster Presentations Adrenal (54 abstracts)
Bilateral adrenal hemangioma cavernosum: NMI and a CT scanning as a complementary methods in newly detected degeneration in one gland
Dragan Tesic 1 , Tijana Icin 1 , Dragana Bogdanovic 2 , Olivera Nikolic 3 , Zoran djermanov 4 & Pavle Budakov 5
1Clinic of Endocrinmology, Diabetes and Metabolic Diseases, Novi Sad, Serbia; 2Institute for Radiology, Sremska Kamenica, Serbia; 3Institute for Radiology, Novi Sad, Serbia; 4Clinic of Abdominal and Endocrine Surgery, Novi Sad, Serbia; 5Institute for Pathology, Novi Sad, Serbia.
Hemangiomas are the rare cases of adrenal incidentalomas, especially in their bilateral forms. Case study: male patient, 65 year, presented after the pain in right upper hemi abdomen, lasted half year. On ultrasonography there was an enlarged right suprarenal gland. Patient was on routine abdominal ultrasonography, with undetectable suprarenal glands, one year before. We concluded that something new happened in the meantime. On NMR the right suprarenal gland was 6.2×4.7 cm, with a peripheral spotty contrast enhancement and centripetal enhancement. Despite the highly suspected typical pattern of enhancement for the diagnosing of adrenal hemangioma, it was not possible distinguishing the adrenal tissue from the liver and kidney tissue making diagnosis of a benign lesion difficult. Left adrenal gland was 3.7×2.7 cm with low signal and postrcontrast patchy enhancement. Potassium, cortisol and catecholamins were in referent values. So we indicated CT scanning which clearly separated the liver from suprarenal tissue. Bone scintigraphy scans was normal. Pathohistology after operation confirmed the diagnosis of cavernosal hemangioma with cystic cavities up to 1 cm, clotting blood, fibrosis, sclerosis and calcifications within the extirpated suprarenal gland. After operation patient insisted that the remaining pain was 1/10 of that preoperatively present. Conclusion: Degenerative process in one adrenal cavernosal hemangiomas led to the development of the pain in abdomen. In this case study MRI better described tissue characteristics and CT its shapes leading to a high suspected preoperative diagnosis.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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