J Korean Endocr Soc.  2008 Feb;23(1):62-65. 10.3803/jkes.2008.23.1.62.

A Case of an Adrenal Hemangioma Mimicking a Pancreatic Tail Tumor

Affiliations
  • 1Department of Internal Medicine, School of Medicine, Pusan National University, Korea.

Abstract

Adrenal hemangiomas are rare non-functioning tumors that originate from the retroperitoneal organs. They are generally asymptomatic, and are usually discovered at autopsy. In 1955, Johnson and Jeppensen reported the first case of a surgically removed adrenal hemangioma. We report a case of adrenal hemangioma that mimicked a pancreatic tail tumor, as detected by computed tomography. We made a diagnosis of an adrenal hemangioma from endoscopic ultrasonography and confirmed the diagnosis following a laparascopic adrenalectomy. If one is suspicious of an adrenal hemangioma, one needs to assess the lesion from every aspect. With the advancement of diagnostic techniques in arteriography, ultrasound, and computed tomography, the frequency of preoperative recognition and diagnosis is on the increase. Still, it is difficult to diagnose an adrenal hemangioma just from an imaging study. One should consider performing surgery for removal of the tumor to rule out a malignancy, and to prevent traumatic rupture. With the case presentation, we review the clinical, radiographic, and pathological features of adrenal hemangiomas.

Keyword

pancreatic neoplasms; adrenal gland neoplasms; hemangioma

MeSH Terms

Adrenal Gland Neoplasms
Adrenalectomy
Angiography
Autopsy
Endosonography
Hemangioma
Pancreatic Neoplasms
Rupture

Figure

  • Fig. 1 A. Abdomen CT showed 4.5 × 3.4 cm sized septated cystic mass with peripheral enhancing portion, arise from lateral lime of Lt. adrenal gland abutting pancreatic tail portion. B. MRI showed cystic mass with internal septal and rim enhancement in the pancreatic tail, which have T1 low, T2 high signal intensity.

  • Fig. 2 EUS showed that a well-circumscribed heterogeneous hypoechoic mass with internal cystic change (A) originated from the lateral rim of the left adrenal gland (B, arrow).

  • Fig. 3 The mass was composed of various sized blood vessels (H&E, orig. mag. ×200). Normal adrenal gland parenchyma was noted on the surface of the mass. There was no histologic evidence of malignancy.


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