Adrenal incidentaloma; a case report
Danda Vijay Shekar Reddy & Paidipally Srinivas
Incidentally found adrenal tumour is one of the most frequent adrenal disorders due to increased availability and use of imaging studies. But a well circumscribed, homogenous calcified adrenal incidentaloma are extremely rare.
We present a case of 68-year-old women who underwent X-ray chest examination for routine health check up, which revealed hyper intense lesion in left sub diaphragmatic area. Further evaluation by a CT scan abdomen revealed hyper dense well circumscribed, homogenous 1000 HU mass of 4.8×3.8 cm in left adrenal area. Her medical history, physical examination results and routine laboratory values are unremarkable except for palpable right thyroid nodule and findings suggestive of follicular neoplasm on FNAC examination. Serum cortisol was supressable, 24 h. urinary VMA and metanephrines were normal. To our knowledge such a adrenal incidentaloma is not reported in literature. Though most of the calcified incidentalomas recquire surgical resection we followed up the case at 3, 6, and 12 months with no change in size.
Careful evaluation and management of adrenal incidentaloma should be individualised based on clinical circumstances, the imaging phenotype and age of the patient rather than more aggressive approach, which is used for younger patients.