Rare cavernous hemangioma of adrenal gland: case report

Imaging findings and 4 years follow-up of adrenal cavernous hemangioma: a case report

Background

Adrenal hemangioma is a rare and non-functional benign tumor. Since the first case in 1955, approximately 90 cases have been reported in literature frequently presenting as a large and incidentally discovered retroperitoneal mass or as a result of hemorrhage caused by spontaneous rupture.

Case presentation

A 69-year-old man was admitted to our hospital for right hypocondrium pain and anemia. A computed tomography (CT) scan was performed and a large right adrenal mass measured 18 cm was found.

The patient underwent laparoscopic right adrenalectomy. Histopathological diagnosis revealed a cavernous adrenal hemangioma.

Conclusion

Cavernous hemangiomas are uncommon tumors. We reported a case of adrenal cavernous hemangioma incidentally discovered by ultrasound and CT. In the case of finding adrenal masses, cavernous hemangiomas, although rare, should be considered a possible diagnosis.

The appropriate treatment is surgical resection to rule out any potential for malignancy, to relieve symptoms secondary to the mass effect, and to prevent complications such as retroperitoneal bleeding.

Clinical Features and Outcomes of Adrenal Cavernous Hemangioma: A Study of 8 Cases from a Single Center

BACKGROUND

Cavernous hemangioma is a rare benign tumor that develops from the adrenal glands. In this study, we present our experience with patients with adrenal cavernous hemangiomas (ACH) in a Chinese population.

METHODS

Demographic, diagnostic, surgical, and pathological findings in patients at a single institution who were adrenalectomized as a result of ACH were retrospectively reviewed.

RESULTS

Among 601 patients who underwent adrenalectomy, 8 (1.33%; 5 men, 3 women) cases were diagnosed with ACH between January 1, 1998, and December 31, 2018, in a single institution. The mean age was 53.25 ± 11.9 years (range, 35-67 years). Four (50%) were asymptomatic, and three (37.5%) complained of abdominal or flank discomfort. Preoperative computed tomography (CT) revealed ACH in 3 (37.5%) cases. Well-defined borders and heterogeneous enhancement with characteristic progressive partial filling-in were characteristic CT features of ACH (tumor size>3 cm). The mean tumor size was 5.16 ± 3.4 cm (range, 1.5-11 cm). No recurrence occurred during a median follow-up period of 38.37 months (range, 8-60 months).

CONCLUSIONS

ACH was asymptomatic in most cases, and diagnosis could be challenging. Adrenalectomy is a safe treatment modality for ACH, and it ensures favorable outcomes.

Adrenal Cavernous Hemangioma: A Rarely Perceived Pathology-Case Illustration and Review of Literature

Cavernous hemangiomas are endothelial tumors that rarely affect the adrenal glands. Most of these tumors remain silent and are incidentally found on abdominal imaging. Hardly ever, these tumors are endocrinologically functional. They may present as vague abdominal pain. Surgical resection remains the mainstay for large masses. In this paper, we are presenting a case of adrenal cavernous hemangioma in a 83-year-old male patient who initially presented for workup of vague abdominal and bilateral flank pain. A computed tomography scan of the abdomen showed an 8 cm right adrenal adenoma which was metabolically nonfunctional. The mass was completely resected through an open subcostal incision, with no encountered postoperative complications. A highlight of all published cases of adrenal hemangiomas since 1955 is also presented and reviewed.

Benign vascular tumors, cysts, and pseudocysts of the adrenal gland: a contemporary multi-institutional clinicopathological analysis of 55 cases

Benign adrenal vascular tumors, cysts, and pseudocysts are a heterogeneous group of relatively uncommon entities that may pose diagnostic challenges radiologically and pathologically. However, there are only a few small cases series systematically characterizing the clinicopathological features of these lesions. We identified 55 cases of benign adrenal vascular tumors, cysts, and pseudocysts (23 pseudocysts, 17 hemangiomas, 8 lymphangiomas, 6 angiomatous endothelial cysts, and 1 arteriovenous malformation) from a multi-institutional urologic pathology database between 2000 and 2017 and retrospectively analyzed their clinicopathological features. We found that these lesions have a female predominance and most are right sided. These lesions may occur simultaneously with other adrenal tumors associated with hormonal hypersecretion. A substantial portion of pseudocysts were semisolid or solid with no fluid collection, mimicking a solid adrenal tumor and resulting in adrenalectomy. In addition, a small proportion of benign vascular lesions may have coexisting epithelial tumors, requiring extensive specimen sampling and thorough microscopic examination.

Giant Cavernous Hemangioma of the Adrenal Gland in an Elderly Patient

Cavernous hemangioma is a rare, non-functional, benign adrenal tumor. Adrenal cavernous hemangioma is often diagnosed after surgery with a histologic examination. A 70-year-old man complaining of appetite loss was admitted to our hospital. An incidental large left adrenal mass was found by computed tomography (CT). There were no clinical signs of adrenogenital syndrome, Cushing's syndrome or primary aldosteronism. Total resection was carried out. The pathological diagnosis was cavernous hemangioma. The differentiation of adrenal tumor is necessary in cases of large tumors, and resection is desirable given the risks of hemorrhaging and rupture.

Adrenal gland hemangioma: A rare case of the incidentaloma: Case report

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Adrenal gland hemangioma is an extremely rare benign vascular tumor.

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It is frequently discovered as incidental radiological findings in abdominal imaging performed for various reasons.

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The preoperative diagnosis is very difficult, generally CT and MR imaging are useful for the diagnosis of hemangioma.

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In front of an adrenal mass discovered incidentally there are several factors to consider: the tumor size, its secreting character or not, imaging data suggestive of malignancy and complications.

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These factors help in determining which incidental adrenal masses should be excised.

Bakground

Adrenal glands hemangiomas are rare, benign and non-functional tumors. They are often discovered as incidentalomas either during imaging or autopsies. Nearly 70 cases were reported in the literature.

Case report

We report a case of a non-functional adrenal hemangioma (AH) that was incidentally found on abdominal ultra sonography (US) during the routine control of diabetes of a 58 year-old man. Imaging with US and Computed tomography (CT) showed an heterogeneous and partially calcified 6 cm tumor of the right adrenal gland. The mass was surgically excised and the histological examination concluded to an adrenal haemangioma.

Conclusion

Although rare, AH should be included in the differential diagnosis of the adrenal neoplasmas.

[Adrenal gland hemangioma: about a case]

L’hémangiome surrénalien est une entité histologique très rare appartenant au groupe des incidentalomes. Il est souvent asymptomatique, de découverte fortuite lors d’un examen d’imagerie sollicité par une autre affection abdominale. Nous rapportons dans ce travail un seul cas permettant d’étoffer la série internationale qui reste jusqu’à nos jours très limitée.

Giant Adrenal Cavernous Hemangioma in a Patient with Familial Adenomatous Polyposis

Adrenal hemangioma is an uncommon benign vascular tumor that is often discovered incidentally. It has never been reported in association with familial adenomatous polyposis. We report a case of a 60-year old man with a history of familial adenomatous polyposis, in whom a huge retroperitoneal cyst of 18x17 cm was discovered during routine radiologic evaluation. Because of the impossibility of ruling out the presence of malignancy, surgical cystectomy was performed, associated to a scheduled total colectomy. Pathological examination revealed that the cyst corresponded to an adrenal cavernous hemangioma. Colonic adenomas did not show signs of degeneration. Screening for adenomatous polyposis coli (APC) gene mutation was not carried out. As familial adenomatous polyposis is known to involve a variety of extracolonic manifestations, this finding raises the suspicion of a possible variant of this syndrome including adrenal hemangioma. An extensive study based on a larger patient series with genetic exploration is necessary.

Beyond hepatic hemangiomas: the diverse appearances of gastrointestinal and genitourinary hemangiomas

Hemangiomas are common lesions, best known for their appearance in the liver. Their appearance in less common locations, such as the gastrointestinal and genitourinary tracts, is less well known. We will review the typical and atypical appearance of hemangiomas in these locations on sonography, CT, and MRI.

Giant adrenal hemangioma: Unusual cause of huge abdominal mass

Adrenal hemangioma is an extremely rare benign and non-functioning neoplasm of the adrenal gland. We report a case of a 71-year-old woman admitted for intermittent abdominal pain and abdominal distension associated with vomiting and chronic constipation for 5 years. Physical examination revealed a large abdominal mass. Both computed tomography scan and magnetic resonance imaging suggested hemangioma in the right lobe of the liver. Laboratory examinations and tumour markers were within normal limits, except for hypochromic microcytic anemia. The mass was removed intact by conventional surgery and histopathology revealed a cavernous hemangioma of the adrenal gland with no signs of malignancy. Surgical resection was curative, with no recurrence at the 2-year follow-up.