Nonfunctional adrenocortical carcinoma initially presenting as retroperitoneal hemorrhage

BMC Surgery

Case Report

Masahiko Ohsawa¹  Seiichi Kitagawa²  Naoyoshi Onoda³  Ryosuke Amano³  Shinichiro Kashiwagi³  Sadaaki Yamazoe³  Satoru Noda³  Koutaro Miura³  Kento Kurata³  Yuka Asano³  Keiichiro Hirata³  Kenjiro Kimura³  Kosei Hirakawa³ 

[1] Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, 545-8585, Osaka, Abeno-ku, Japan;Department of Physiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, 545-8585, Osaka, Abeno-ku, Japan;Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, 545-8585, Osaka, Abeno-ku, Japan;

关键词: Adrenocortical carcinoma;    Retroperitoneal hemorrhage;    Mitotane;    Interventional radiology;    Surgery;   

DOI  :  10.1186/s12893-015-0031-3

 received in 2014-04-01, accepted in 2015-04-01,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAcute adrenal hemorrhage is an uncommon entity. Although trauma is the most common cause of adrenal hemorrhage, non-traumatic etiologies have also been reported. We report an unusual case of a spontaneously ruptured adrenocortical carcinoma that initially presented as a critical massive retroperitoneal hemorrhage. The case was treated successfully using a combination of emergency interventional radiology and elective surgery.Case presentationA 47-year-old woman was transported to our hospital because of the sudden onset of severe pain in her left lower back. The shadow of a tumor-like soft mass accompanied by bleeding was observed in the upper pole of the left kidney, together with vascular leakage from the middle suprarenal artery on computed tomography. Transcatheter embolization of the left middle adrenal artery was administered based on a diagnosis of acute adrenal hemorrhage. Further observation indicated that the bleeding was caused by rupture of an adrenocortical carcinoma. Left adrenalectomy was subsequently carried out via laparotomy.ConclusionsWe experienced an unusual case of acute massive adrenal hemorrhage caused by the rupture of a non-functional adrenocortical carcinoma, which was treated successfully by ambulatory transcatheter embolization therapy and elective surgery.

【 授权许可】

CC BY   
© Kashiwagi et al.; licensee BioMed Central. 2015