Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (2): 37-42.doi: 10.6040/j.issn.1671-7554.0.2021.1374

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Clinical and imaging features of adrenal cavernous hemangioma

SONG Yufeng1, NING Hao1,2, YAO Zhigang3, WU Haihu1,2, LIU Feifan1, LYU Jiaju1,2   

  1. 1. Department of Urology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250021, Shandong, China;
    2. Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China;
    3. Department of Pathology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2022-01-25

Abstract: Objective To analyze the clinical and imaging data of adrenal cavernous hemangioma(ACH), and to summarize the characteristics, diagnosis and treatment experience of the disease. Methods The clinical and imaging data of 6 cases of ACH confirmed by postoperative pathology during Jan. 2011 and Jul. 2021 were retrospectively analyzed, and relevant literatures were reviewed. Results The average age of the patients was 56.8 years(33-69 years). Adrenal tumor was detected in 4 cases during physical examination, and in 2 cases due to hypertension or abdominal discomfort. Blood pressure increased in 4 cases, 2 of which had a history of paroxysmal blood pressure fluctuation. Preoperative MRI enhanced scan was performed in 1 case, which was then diagnosed as hemangioma, and the other preoperative diagnoses included pheochromocytoma(n=2), cyst(n=2)and adenoma(n=1). The average maximum diameter of tumor was 4.2 cm(2.0-7.1 cm). All patients underwent laparoscopic unilateral adrenalectomy. During the median follow-up of 13.5 months(4-130 months), no tumor recurrence was observed, and the 2 patients with a history of paroxysmal blood pressure fluctuation had significant remission. Conclusion ACH is a rare benign adrenal tumor with hidden clinical symptoms, and some patients may have abdominal discomfort and paroxysmal blood pressure fluctuation. The imaging characteristic is delayed inhomogeneous centripetal enhancement, and plain scan with point calcification and edge nodular enhancement can assist the diagnosis. Large-volume ACH needs to be differentiated from pheochromocytoma. The filling speed of contrast medium in enhanced scanning can be used as an important identification point. The combination of CT and MRI can improve the diagnostic accuracy. Laparoscopic surgery is the preferred treatment.

Key words: Adrenal tumor, Adrenal cavernous hemangioma, Hypertension, Imaging, Diagnosis, Treatment

CLC Number: 

  • R737.11
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