title: Adrenal cavernous hemangioma: a case report with review of the literature.
abstract: BACKGROUND
  Adrenal cavernous hemangioma is a rare type of tumor that is usually diagnosed post-operatively. There have only been approximately 63 cases reported in the literature to date.
  
  
  METHODS
  We report a case of adrenal cavernous hemangioma in a 27-year-old pregnant woman. The mass was discovered on ultrasonography when she visited a gastroenterologist for vague epigastric discomfort and vomiting. The laboratory tests were within normal limits and did not show any features suggestive of adrenal endocrinologic dysfunction. Computed Tomography (CT) revealed a well-defined 7.8 × 7.8 oval mass in the right adrenal gland with speckled calcifications. The mass was removed by transabdominal laparoscopic surgery. Strong positive immunostaining for CD31 and CD34 with weakly positive staining for podoplanin/D2-40 confirmed the diagnosis of cavernous hemangioma.
  
  
  CONCLUSIONS
  We reviewed 52 case reports of adrenal cavernous hemangioma in an attempt to identify tumor characteristics. More than half of the patients reviewed showed a heterogeneous internal structure of the mass with peripheral patchy enhancement on CT. They also showed focal or speckled calcifications either on X-ray or CT. Nevertheless, many of these characteristics overlap with the imaging phenotypes of other common diseases of the adrenal gland and therefore do not seem to provide definite evidence for differential diagnosis. Laparoscopic approach is a feasible and safe modality to remove adrenal cavernous hemangiomas because they seem to form a rigid fibrotic capsule; hence the risk of bleeding due to surgical manipulation is relatively low.
authors.affiliation: Division of Hepatobiliary and Pancreas, Department of Surgery, Yonsei University, College of Medicine, Seoul, Korea. jnohmd@outlook.com.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Noh
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Choi
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D001706:Biopsy; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography