A rare coexistence of adrenal cavernous hemangioma with extramedullar hemopoietic tissue: a case report and brief review of the literature

Abstract

Background: Cavernous hemangiomas of the adrenal gland are rare, benign, non-functioning neoplastic tumors. To our knowledge, 55 cases have been reported in the literature to date.

Case presentation: We report the first case of a large, non-functioning adrenal cavernous hemangioma that was incidentally found during the preoperative staging workup of a 75 year old woman with left breast adenocarcinoma. Imaging with US, CT scan and MRI showed a heterogeneous 8 cm mass with non-specific radiological features that was located on the left adrenal gland. The mass was surgically excised and pathology revealed an adrenal hemangioma with areas of extramedullar hemopoiesis.

Conclusion: Although adrenal hemangiomas are rare and their preoperative diagnosis is difficult, they should always be included in the differential diagnosis of adrenal neoplasms.

Figure 1

MRI scan of a left adrenal hemangioma demonstrating hyperintensity on T1-weighted image with a fat component.

Figure 2

MRI scan of a left adrenal hemangioma demonstrating hyperintensity on T2-weighted image and irregular peripheral enhancement.

Figure 3

Gross section of adrenal hemangioma showing macrocystic, haemorrhagic surface.

Figure 4

Histological appearance of the adrenal hemangioma (hematoxylin-eosin × 25).

Figure 5

Histological section of the adrenal hemangioma showing a focus of extramedullar hemopoiesis (hematoxylin-eosin × 25).