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Adrenal hematoma

Case contributed by Dr Henry Knipe

Presentation

Trauma.

Patient Data

Age: 60 years
Gender: Male
CT

Right adrenal mass (HU 60). Right L1, L2 and L5 transverse process fracture. Subcutaneous fat stranding in a seatbelt pattern. No further traumatic injury with a small volume of left retroperitoneal fluid. 

Four months later

CT

Both adrenal glands have a normal appearance with no mass lesion. This confirms the right adrenal mass on the previous CT as a hematoma. Small hiatus hernia. Small right lumbar hernia is partially imaged.

Case Discussion

Incidental adrenal lesions need to be followed up if there is no preceding imaging that confirm the benign nature (no growth, or appropriate HU values to indicate it is an adenoma). This case demonstrates normal adrenal glands, indicating the prior adrenal mass is in fact an adrenal hematoma. 

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