[An adrenal incidentaloma in a trauma patient; a plea for expectant management].
An adrenal incidentaloma was detected in 45-year-old female driver after a car-versus-car collision. The mass, which had a diameter of 5.4 cm, was not a hormone-producing tumour, but because of its size laparoscopic adrenalectomy was performed 2 months later. Pathology examination revealed an old haematoma situated centrally in the right adrenal gland. Posttraumatic adrenal haematoma is found in 25% of autopsies of traumatized patients. Most adrenal haematomas have an ovoid appearance on CT and have a slight hyperattenuation. Follow-up CT of an adrenal haematoma shows a decrease in size and attenuation. It is therefore proposed that adrenal incidentalomas detected during trauma screening should be evaluated by repeating CT after 3 months. If the mass has diminished and its density decreased, it is most probably an adrenal haematoma, in which case unnecessary surgery may be avoided.
van Westreenen
H L
HL
Isala klinieken, Postbus 10.400, 8000 GK Zwolle. h.l.van.westreenen@isala.nl
Patijn
G A
GA
Sijbrandij
E S
ES
Oosterhuis
J W A
JW
D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000315:Adrenalectomy; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014947:Wounds and Injuries