Endocrine Abstracts

Introduction: Adrenal cavernous hemangioma is a rare tumor with few cases reported in the world. Usually this adrenal masses are incidentally discovered and non functional.

Case report: We describe the case of a 63 year old male patient with a history of hypertension and treated prostate. He was referred to our endocrinology department with complaints of his left lower back. At the admission the BMI was 21 kg/m², his blood pressure was 160/90 mmHg and the heart rate was 84 beats /mn. In the clinical examination there were no clinical signs of hypercortisolism or catecholamine or mineralocorticoid excess. The abdominal enhanced C T showed a left large heterogeneous adrenal tumor of 50 mm with hemorrhage, necrosis and calcification, the C T value of solid part was 30 UH. The laboratory evaluation revealed a morning cortisol level of 179 nmol/l after a 1 mg overnight dexamethasone suppression test and a low ACTH concentration. The plasma metanephrine, normetanephrine, aldosterone level and renine activity were normal. All these features make it difficult to distinguish from a primary adrenal cortical carcinoma and then required operative management. An adrenalectomy was performed and the tumor was safely completely resected with no evidence for local invasion. The results of pathological examinations were in favor of a cavernous hemangioma of the left adrenal gland.

Conclusion: Adrenal cavernous hemangioma is a rare tumor that can have a very large size, and it is difficult to differentiate from adrenal cortical carcinoma clinically or radiologically.