Adrenal calcification is not a rare finding in healthy asymptomatic people, and is usually the result of previous haemorrhage, or tuberculosis. Addison's disease patients only occasionally have calcification.
- sepsis: Waterhouse-Friderichsen syndrome
- blunt abdominal trauma
- adrenal pseudocyst
- neonatal asphyxia
- infants: calcification seen soon after haemorrhage (as early as 1-2 weeks)
- adrenal metastases, especially melanoma
- adrenal myelolipoma
- adrenal adenoma
- adrenocortical carcinoma
- uncommon in primary Addison disease; calcification suggests an underlying cause (e.g. infection)
- Wolman disease
This is best assessed on CT where simple adrenal calcification can also be differentiated from a calcified adrenal mass or lesion. CT also for simultaneous characterisation of any underlying lesions with size, density, enhancement and washout.
In children neuroblastoma has reported as the commonest calcifying adrenal mass 4. In adults calcified simple cysts have been reported as common adrenal masses, characteristically showing peripheral curvilinear calcification.
Post-haemorrhage calcification is usually seen after the initial adrenal haematoma has resolved and, hence, is not usually seen with an adrenal lesion. However, adrenal metastases such as from bronchogenic tumours can present with haemorrhage, making the diagnosis challenging.
- 1. Armstrong P, Wastie ML, Rockall AG. Diagnostic imaging. Wiley-Blackwell. (2004) ISBN:1405102306. Read it at Google Books - Find it at Amazon
- 2. Adrenal Hemorrhage Imaging by Dawn Light from emedicine.com. Adrenal Hemorrhage Imaging
- 3. Becker KL. Principles and practice of endocrinology and metabolism. Lippincott Williams & Wilkins. (2001) ISBN:0781717507. Read it at Google Books - Find it at Amazon
- 4. Kenney PJ, Stanley RJ. Calcified adrenal masses. Urol Radiol. 1987;9 (1): 9-15. Pubmed citation