Non-surgically treated case of nonfunctioning ruptured adrenal adenoma in a patient on hemodialysis

Endocrine. 2019 Jul;65(1):213-216. doi: 10.1007/s12020-019-01948-3. Epub 2019 May 9.

Abstract

Objectives: Herein, we report a case of rupture of nonfunctional adrenal adenoma treated by nonsurgical supportive management due to high risk for operation.

Method and case: A patient with end stage renal disease (ESRD) who was on hemodialysis visited our emergency room and complained of a sudden abdominal pain after a fall. A retroperitoneal hemorrhage with hematoma formation around the adrenal adenoma, which was caused by rupture of the adrenal adenoma, was detected by abdominal computed tomography (CT).

Results: Supportive management was performed, with serial CT follow-up instead of surgical adrenalectomy treatment because of high operative risk, due to hemodialysis. After 1 week, the patient's vital signs stabilized and the patient did not further complain about abdominal symptoms. However, supportive embolization was performed and the size of hematoma was more decreased.

Conclusion: We report a case of a patient on hemodialysis who experienced a rupture of a nonfunctioning adrenal adenoma, which was caused by low-energy trauma. The patient's conditions improved with nonsurgical supportive management including embolization.

Keywords: Adrenal adenoma; Embolization; Hemodialysis; Rupture.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / therapy
  • Adrenal Cortex Neoplasms / complications
  • Adrenal Cortex Neoplasms / pathology
  • Adrenal Cortex Neoplasms / therapy*
  • Adrenocortical Adenoma / complications
  • Adrenocortical Adenoma / pathology
  • Adrenocortical Adenoma / therapy*
  • Aged
  • Embolization, Therapeutic*
  • Gastrointestinal Hemorrhage / therapy
  • Hematoma / complications
  • Hematoma / therapy
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Male
  • Renal Dialysis*
  • Retroperitoneal Space / pathology
  • Rupture, Spontaneous / complications
  • Rupture, Spontaneous / pathology
  • Rupture, Spontaneous / therapy*