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Case Reports
. 2021 Feb 16;16(4):979-982.
doi: 10.1016/j.radcr.2021.02.008. eCollection 2021 Apr.

Successful transcatheter arterial embolization for ruptured adrenocortical tumor in a pediatric patient

Miki Yoshida  1 , Hiroaki Takahashi  2 , Yuni Yamaki  3 , Fumiko Chiba  4 , Kensaku Mori  5
Affiliations
Case Reports

Successful transcatheter arterial embolization for ruptured adrenocortical tumor in a pediatric patient

Miki Yoshida et al. Radiol Case Rep. .

Erratum in

Abstract

Adrenocortical tumors (ACTs) are rare in children and should be treated as malignant tumors. A 12-year-old female patient was referred to our institute for acute abdomen and hypovolemic shock. She had symptoms of virilization, including lowered voice, beard growth, and hirsutism. An elevated level of dehydroepiandrosterone sulfate was observed, and computed tomography scan showed a large left adrenal mass with massive hemorrhage. Emergency transcatheter arterial embolization was successfully performed using N-buthyl-2-cyanoacrylate as an embolic material. She underwent surgical resection on the following day. Histopathological analysis showed strong degeneration of the tumor and its necrosis, and the tumor was diagnosed as ACT of unknown grade. To our knowledge, this is the first case of a ruptured ACT treated with transcatheter arterial embolization in a pediatric patient.

Keywords: ACT, adrenocortical tumor; Adrenocortical tumor; CT, computed tomography; DHEA-S, dehydroepiandrosterone sulfate; N-butyl-2-cyanoacrylate; NBCA, n-butyl-2-cyanoacrylate; Pediatric; Rupture; TAE, transcatheter arterial embolization; Transarterial embolization.

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Figures

Fig. 1 –
Fig. 1
Coronal contrast-enhanced CT image shows a large left suprarenal retroperitoneal mass with massive hemorrhage measuring 13 cm in diameter (arrows).
Fig. 2 –
Fig. 2
Left inferior phrenic arteriogram shows the left superior adrenal artery supplying the tumor (arrow).
Fig. 3 –
Fig. 3
Left middle adrenal arteriogram shows the tumor stain.
Fig. 4 –
Fig. 4
Fluoroscopy image during TAE of the left inferior adrenal artery using NBCA diluted with iodized oil shows the radiopaque casts of the embolisant in the left superior, middle, and inferior adrenal arteries and a 1.6-F inner microcatheter (arrowhead) coaxially advanced through a 2.6-F high-flow microcatheter (arrow).
See this image and copyright information in PMC

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