Case Report Details Surgical Removal of Rare Adrenal Tumor in Elderly Patient

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by Alice Melao |

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Cavernous hemangioma adrenal

Removing asymptomatic benign tumors that grow in the adrenal gland is safe and effectively reduces health-risks associated with these tumors in elderly patients, a case report suggests.

The report, “Giant Cavernous Hemangioma of the Adrenal Gland in an Elderly Patient” was published at Internal Medicine, the journal of the Japanese Society of Internal Medicine.

Cavernous hemangioma is a rare, non-functional, benign tumor that develops in the adrenal gland. To date, only 63 cases have been reported, and only 5.8 percent induced hormone imbalance and subclinical Cushing’s syndrome.

Cushing’s is caused by high amounts of glucocoticosteroids in the blood. The most common cause is benign overgrowth of the pituitary or adrenal glands, leading to uncontrolled production of the adrenocorticotropic hormone (ACTH) or cortisol, respectively.

Patients with cavernous hemangioma usually do not show specific symptoms that indicate presence of the tumor. In most cases it is detectable only after surgery and tissue analysis.

Advances in imaging techniques have improved the detection of adrenal tumors. However, previous studies have shown that cavernous hemangiomas do not have specific imaging characteristics that can allow their identification, making their detection and diagnosis challenging.

“The differentiation of an adrenal tumor is necessary in cases of large tumors, and resection is desirable given the risks of hemorrhaging and rupture,” the researchers stated.

A research team at Toho University Graduate School of Medicine, in Japan, presented the case of a 70-year-old man with a giant cavernous hemangioma of the adrenal gland.

The patient did not have any major symptoms or medical history, only complaining of loss of appetite. Physical examination revealed a large adrenal mass, palpable mass on the left upper lateral region of the abdomen, and an adrenal mass was confirmed via computed tomography (CT) scan imaging.

Blood tests did not reveal cortisol or other hormone deregulation. Also, clinical and biochemical analysis failed to detect any clinical signs of Cushing’s syndrome.

The team surgically removed the adrenal mass, which weighed 2 kilograms (4.5 pounds). Further tissue analysis revealed the mass had vascular origin, which confirmed the diagnosis of cavernous hemangioma.

“Resection of this rare neoplasm [tumor growth] are to relieve mass-effect-type symptoms, to exclude malignancy, and to treat complications such as hemorrhaging,” the researchers stated.