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World Journal of Surgery

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01-01-2012

Spontaneous Adrenal Hemorrhage with Associated Masses: Etiology and Management in 6 Cases and a Review of 133 Reported Cases

Authors: Jennifer L. Marti, John Millet, Julie Ann Sosa, Sanziana A. Roman, Tobias Carling, Robert Udelsman

Published in: World Journal of Surgery | Issue 1/2012

Abstract

Background

Spontaneous adrenal hemorrhage associated with a mass is uncommon and treatment strategies are not standardized. Current treatment modalities range from supportive management and blood transfusion to embolization or immediate operative extirpation. Our objectives were to describe six cases from a single institution and to perform a literature review of the etiology of the condition and recommended management of patients with hemorrhagic adrenal masses.

Methods

Records from six patients diagnosed with adrenal hemorrhage and an associated mass at a single institution were reviewed. Clinical records and outcomes were analyzed. A comprehensive review of 133 reported cases in the literature was performed.

Results

Six patients presented with spontaneous adrenal hemorrhage that appeared to be associated with a mass, with tumor sizes ranging from 3.7 to 15 cm. Three patients underwent adrenalectomy for pheochromocytoma or adrenocortical cancer. Three patients did not undergo adrenalectomy: one had a metastasis from lung cancer, one underwent embolization, and one had resolution of the mass on interval imaging. A comprehensive review of the literature identified 133 cases, with pheochromocytoma the most commonly reported lesion (48%).

Conclusions

Spontaneous adrenal hemorrhage is rare. When it does occur, a high level of suspicion for malignant disease or pheochromocytoma should be maintained. The possibility of a hematoma masquerading as a neoplasm should also be considered. In cases of ongoing hemorrhage, embolization may be a lifesaving temporizing measure. Acute surgical intervention should be considered in selected patients, and surgery may not be required in all patients. A cautious approach with a comprehensive biochemical and imaging work-up is advised prior to operation.

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Title: Spontaneous Adrenal Hemorrhage with Associated Masses: Etiology and Management in 6 Cases and a Review of 133 Reported Cases
Authors: Jennifer L. Marti
John Millet
Julie Ann Sosa
Sanziana A. Roman
Tobias Carling
Robert Udelsman
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 1/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1338-6

ACC 2024 Congress

Springer Medicine

Spontaneous Adrenal Hemorrhage with Associated Masses: Etiology and Management in 6 Cases and a Review of 133 Reported Cases

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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