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

  • Endocrine imaging
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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.

Learning point for clinicians

Physicians should consider both surgical and nonsurgical management for the rupture of adrenal adenomas, depending on the patient situation. Therefore, nonsurgical supportive management such as embolization can be one therapeutic option for treating nonfunctioning adrenal adenoma rupture caused by low-energy trauma in a patient who has risks for operation due to combined comorbidities.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University, Medical School, Research Institute of Clinical Medicine of Chonbuk National University - Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, South Korea

    Kyung Ae Lee & Heung Yong Jin

Authors
  1. Kyung Ae Lee
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  2. Heung Yong Jin
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Correspondence to Heung Yong Jin.

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Lee, K.A., Jin, H.Y. Non-surgically treated case of nonfunctioning ruptured adrenal adenoma in a patient on hemodialysis. Endocrine 65, 213–216 (2019). https://doi.org/10.1007/s12020-019-01948-3

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  • DOI: https://doi.org/10.1007/s12020-019-01948-3

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