PMC5722048_01
Plain CT prior to AVS. CT detected an adrenal mass 1.4 cm in diameter (arrows).
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F1
At the age of 56 years, ultrasound identified a right adrenal mass during a routine medical check-up and CT confirmed a 1.4 cm adrenal mass (Fig. 1).
Fluoroscopy images immediately after AVS. Left: LAO90, CRA0; right: RAO90, CRA0. The patient complained of chest discomfort and back pain after AVS, and pooling of contrast medium was noted at that time in the entire right adrenal gland (dotted circle).
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F2
Plain CT after AVS. Immediately after AVS, pooling of contrast medium in the entire right adrenal gland was observed (arrow).
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F3
AVS revealed a hematoma and pooling of contrast medium in the right adrenal gland (Fig. 3). Although chest and back pain continued, the ECG and laboratory findings ruled out myocardial ischemia.
Results of AVS. Blood sampling site numbers are in parentheses. Plasma aldosterone concentration (pg/mL)/plasma renin activity (ng/mL/h) = aldosterone-renin ratio.
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F4
The results of AVS at 15 sites are shown in Figure 4.
Plain CT at 60 days after AVS. The hematoma is smaller, but the adrenal gland is slightly enlarged (arrows).
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F5
The right adrenal gland hematoma was followed up by CT for 60 days (Fig. 5).
Cut surfaces of the resected right adrenal gland. The adrenal gland shows focal necrosis and hemorrhage cystic change, probably due to AVS.
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F6
Pathological examination of the resected adrenal gland showed that the tumor was heterogeneous, ranging from large lipid-rich cells to smaller cells with relatively little lipid and cells with compact eosinophilic cytoplasm (Fig. 6).