Hepatic growths mimicking adrenal tumors.
OBJECTIVE
The upper district of the perirenal space is widely open and compliant, especially on the right side. Hepatic growths can, therefore, easily invade the adrenal gland area, mimicking adrenal tumors and vice-versa for adrenal and renal tumors. Data on the nature and exact origin of a mass in this region are important for appropriate preoperative management, surgical approach and prognosis but, sometimes, even modern imaging fails in this design.


METHODS
The records and imaging documentation of 42 patients with a mass exceeding 6 cm in the hepatorenal space, have been retrospectively reviewed and compared with surgical and histological findings.


RESULTS
Among the 14 patients with "non-functioning adrenal tumors," the preoperative diagnosis had been accurate in all but 2 cases where the suspected adrenal lesion turned out, intraoperatively, to be liver growths. These 2 cases are discussed in detail.


CONCLUSIONS
The distinction between an intrahepatic and extrahepatic mass challenges modern imaging techniques, and even invasive procedures sometimes fail. A deceptive diagnosis may lead to inappropriate preoperative management and surgical procedures.
Del Gaudio
A
A
Department of Surgery, University of Bologna, School of Medicine, Italy.
Solidoro
G
G
Del Gaudio
G A
GA
Fuzzi
N
N
Bragaglia
R
R
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies