PMC6449812_01
Case 1. (a) Discrete, enlarged, rounded right adrenal gland (18.7 mm),
the day before an episode of acute haemorrhage. (b) Preoperative CT
examination of the abdomen, post-contrast. A strongly enhancing right
adrenal mass (arrows) is surrounded by a poorly defined
non-contrast-enhancing area of hypoattenuation (asterisks), extending
between the renal fossa of the caudate lobe of the liver to the right
renal vein. There is ventral displacement and compression of the caudal
vena cava (arrowhead). (c) The excised adrenal gland with an adherent
peripheral haematoma
10.1177_2055116919840828-fig1.jpg
PMC6449812_01_10.1177_2055116919840828-fig1.jpg
fig1-2055116919840828
On abdominal ultrasonography the right adrenal gland was enlarged, rounded and discrete (19 mm diameter) (Figure 1). There was a large, localised right retroperitoneal effusion with marked mass effect and no evidence of abdominal or thoracic metastases (Figure 1). At surgery to remove the right adrenal gland (Figure 1), via a ventral midline approach, a haematoma (45 mm diameter) was observed in close proximity to the right adrenal gland, just ventral to the caudal vena cava.
PMC6449812_02
Case 2. (a,b) Right adrenal tumour adherent to, but not invading, the
caudal vena cava. (c) The excised adrenal tumour containing (d)
extensive areas of intratumoral necrosis and haemorrhage
10.1177_2055116919840828-fig2.jpg
PMC6449812_02_10.1177_2055116919840828-fig2.jpg
fig2-2055116919840828
The adrenal mass contained a large amount of intratumoral haemorrhage and necrosis on cut section (Figure 2).