Endocrine Abstracts

Case 1: A 57-year-old lady referred to the Endocrinology department due to a CT Abdomen, performed for abdominal pain, reporting the presence of an incidental left adrenal adenoma. Imaging was reviewed in the Adrenal MDT meeting and further CT Abdomen arranged. Images were reviewed before and after oral contrast. Pre-contrast images revealed a small volume of high-density material within a rounded structure in the left upper quadrant, immediately superior to the left adrenal. The oral contrast then went on to fill the stomach and this structure – indicating this as a gastric diverticulum (neck measuring 1.4cm, with both food material and contrast present within the diverticulum). A normal appearance of the adrenal glands was noted.

Case 2: A 54-year-old male presenting with left sided pleuritic chest pain. CTPA was performed; with no evidence of pulmonary emboli but a 30mm lipid rich adenoma in the left adrenal gland was reported. On re-review of this scan in the Adrenal MDT meeting, normal adrenal glands were noted and this adrenal adenoma was reclassified to infact be a gastric diverticulum.

Case 3: A 60-year-old lady presenting with concerns relating to weight gain and skin changes, having requested referral to Endocrinology due to her own worry that an adrenal cancer was underlying these symptoms. Biochemical testing and CT Adrenals were arranged which excluded this, but did highlight the presence of a gastric diverticulum.

Conclusions: This case series highlights three patient cases in which an adrenal adenoma has been initially identified, but following re-review of imaging these have been reclassified as Gastric Diverticulum. This is an important differential to be excluded prior to extensive biochemical assessment of potential hormone excess, especially with the increasing number of scans being performed and incidental diagnoses identified.