Presentation
Incidental finding on an abdominal plain film done for vague abdominal pain.
Patient Data
Age: 55 years
Gender: Male
From the case:
Adrenal calcifications - bilateral
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Plain abdominal radiograph shows bilateral triangular foci of calcifications near the adrenal lodge, compatible with bilateral adrenal calcifications.
Case Discussion
This patient had a past medical history of adrenal hemorrhage. If this was not known then the differential diagnosis for this incidental findings includes:
Hemorrhage
- sepsis : Waterhouse-Friderichsen syndrome
- blunt abdominal trauma
- neonatal asphyxia
- coagulopathy
- infants : calcification seen soon after hemorrhage (as early as 1 - 2 weeks)
Infection
- tuberculosis
- histoplasmosis
Adrenal tumors
- metastases : especially melanoma
- neuroblastoma
- adrenal myelolipoma
- adrenal adenoma
- adrenocortical carcinoma
- pheochromocytoma
Other
-
Addison disease
- uncommon in primary Addison disease; calcification suggests an underlying cause (e.g. infection)
- Wolman disease