Endocrine Abstracts

JOINT1092

A 15-year-old female with a history of splenectomy following a road traffic accident complicated by intestinal obstruction and laparotomy at age of 8, was referred in 2024 for evaluation of left adrenal incidentaloma. The lesion has been discovered in abdominal CT scan performed to investigate recurrent urinary tract infection (UTIs). Up on her review in our clinic, she had no hypertension, hypokalemia and symptoms suggestive of pheochromocytoma or Cushing’s syndrome. Her menarche started at age of 13 and has reported regular menstrual cycles with no hirsutism or acne. There was no personal or family history of endocrinopathies, HTN, or stroke in young. On physical examinations she was well-developed with no Cushingoid features or hyperandrogenism. Biochemical tests were normal including a cortisol suppression of 1.0 mg/dl with 1 mg dexamethasone suppression test and plasma metanephrine. Adrenal CT scan demonstrated a suspicious characteristic of a large (4.8 x 4.5 cm) well-defined left suprarenal homogenous lesion of (49 HU precontrast, 101 HU venous phase and 70 HU delayed) with absolute washout of 59.6% and indeterminate relative washout of 30.7%. For that, androgen levels were requested and came normal and has been referred to urology team for surgical intervention. The patient underwent laparoscopic adrenalectomy, which was converted to open surgery due to extensive adhesions from the previous abdominal surgery. Intra-operatively, the left adrenal gland appeared normal and a left peri-adrenal area mass was noted and excised. The histopathological examination of the excised tissue revealed unremarkable splenic tissue, with no evidence of malignancy.