Adrenal calcifications - bilateral

Case contributed by Dr Maxime St-Amant

Presentation

Incidental finding on an abdominal plain film done for vague abdominal pain.

Patient Data

Age: 55 years
Gender: Male

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
Adrenal tumors
Other
  • Addison disease 
    • uncommon in primary Addison disease; calcification suggests an underlying cause (e.g. infection)
  • Wolman disease

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