副腎血腫の1例

Abstract

45歳男.検診で高脂血症を指摘され, 近医で腹部超音波検査を受けたところ右副腎に腫瘍が認められ精査目的に受診した.MRI上, 腫瘍部はT1強調像で筋肉よりやや低信号を示し一部高信号, T2強調像では高信号でやや不均一に描出され, 血管腫が強く疑われた.しかし腫瘍のサイズは径7cmと大きく悪性腫瘍も否定できなかったため右副腎摘除術を施行し, 病理組織学的所見から副腎血腫と診断した

A right adrenal tumor was discovered incidentally in an ultrasonographic exam in a 45-year-old man. He was referred to our hospital for further examination and treatment of the adrenal tumor. The hormonal levels in his blood and urine were normal and hypertension was not observed. An ultrasonograph, computerized tomographic scan and magnetic resonance imaging showed a right adrenal tumor 7 cm in size. An adrenal hemangioma was most suspected, but a malignant tumor could not be excluded due to its size. Accordingly, a right adrenalectomy was performed. The histological diagnosis of adrenal hematoma was made. Adrenal hematoma is a rare disease in adults. It is very difficult to distinguish a large adrenal hematoma from a malignant tumor, the final diagnosis has to be made by histological study of the resected specimen.