SPONTANEOUS UNILATERAL ADRENAL HEMATOMAS - A SERIES OF 10 CASES

Spontaneous unilateral adrenal haematoma is a very rare condition. We report 10 such cases in which the pathological examination confirmed t he diagnosis and for which computed tomography (CT) (n=10) and magneti c resonance imaging (MRI) (n=5) were performed. The diagnosis of this condition was difficult because there was no specific clinical setting nor any specific functional disorder. CT most often revealed a large mass (> 4 cm) of one of the adrenal glands, most often displaying soft -tissue attenuation and thus not specific. However, MRI suggested the diagnosis, showing foci of hypersignal on T1-weighted images and heter ogeneous masses on Ta-weighted images, predominantly displaying hypers ignal and not enhancing, after Gd-DTPA dynamic perfusion study. Pathol ogic examination of the surgical specimen confirmed either idiopathic haematoma (n=5) or haematoma possibly associated with a small bening t umour (n=5). The diagnosis of adrenal haematoma must be considered whe n an unilateral isolated large adrenal mass is discovered in an asympt omatic patient, MRI with Gd-DTPA dynamic perfusion study has to be per formed and one may suggest waiting and repeat imaging (so as to follow decrease in size or signal changes) in order to avoid surgery.