Cavernous Haemangioma of the Adrenal Gland: A Case Report with Review of Literature

International Journal of Anatomy, Radiology and Surgery. 2019 Oct, Vol-8(4): RC03-RC05 CASE REPORT A 79-year-old male patient with complaints of non-progressive dull right flank pain for the last 2 months reported to the clinic. There were no associated constitutional symptoms with no loss of weight or appetite. The general physical examination and blood profile including hormone levels were within normal limits. A 2×2cm soft to firm mass was palpable in the right lumbar region. The patient underwent Contrast Enhanced Computed Tomography (CECT) after the written informed consent, ensuring renal parameters is within normal limits. The CECT showed a large round to oval heterogeneous mass lesion measuring approximately 7.6×7.0×7.3 cm in dimensions located in right suprarenal region with non-visualisation of the right adrenal gland. There were no appreciable areas of fat attenuation or haemorrhage within [Table/ Fig-1]. Post-contrast images demonstrated peripheral nodular enhancement on arterial phase progressing to partial centripetal fill-in on venous and delayed phases. Even on delayed phase scan, the entire lesion did not show contrast enhancement or fill in attributable to the large area of necrosis. There was compression, but no frank invasion of adjacent liver parenchyma. The right kidney was displaced inferiorly by the mass with maintained intervening planes [Table/Fig-2]. Contralateral kidney and adrenal gland were unremarkable. The IVC and right renal vein showed no filling defect. Surgical removal of the right suprarenal gland was done considering suspicion of malignant aetiology. The intra and postoperative period were uneventful. On gross examination, the mass was globular in shape with a smooth surface. The cut surface reveals haemorrhagic and cystic areas within. Microscopic examination revealed well encapsulated tumour showing dilated vascular spaces lined by endothelial cells along with areas of necrosis as well as presence of cortical cells in vicinity [Table/Fig-3]. The patient is stable and symptom free since 6 months and on follow up till date.