A CASE OF GIANT IDIOPATHIC ADRENAL HEMATOMA

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  • KOIZUMI Masaru
    Department of Surgery, Jichi Medical University School of Medicine
  • SATA Naohiro
    Department of Surgery, Jichi Medical University School of Medicine
  • SAKUMA Yasunaru
    Department of Surgery, Jichi Medical University School of Medicine
  • SHIMIZU Atsushi
    Department of Surgery, Jichi Medical University School of Medicine
  • HYODO Masanobu
    Department of Surgery, Jichi Medical University School of Medicine
  • YASUDA Yoshikazu
    Department of Surgery, Jichi Medical University School of Medicine

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  • 巨大な特発性副腎血腫の１例

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Abstract

A 74-year-old man, with no history of abdominal trauma, developed constipation, and a tumor was detectcd in the left upper abdomen on ultrasonography (US). ; the approximately 20-cm tumor moved with breathing. US and computed tomography revealed a poorly enhanced tumor with central necrosis pressing on the left kidney and spleen. Magnetic resonance imaging showed liquid degeneration at the center of the tumor. The left adrenal, left sub-phrenic, and splenic arteries were detected as feeding vessels on angiography. All tumor markers and adrenal hormone levels were within normal limits. A preoperative diagnosis of a neurogenic tumor was made ; the tumor was resected. The tumor did not invade adjacent organs. The weight of the resected tumor was 4700 g. On histopathology, an adrenal hematoma without neoplastic findings was diagnosed. Thus, an idiopathic adrenal hematoma, with no hemorrhagic tendency, was found. This is a rare disease, and a precise preoperative diagnosis is difficult to make. However, surgery can possibly be avoided, if a hematoma is considered in the preoperative differential diagnosis.

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