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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2006 December;19(6):459-62
Adrenal ectopic intrahepatic tissue: clinical case and literal review
Candela G., Varriale S., Di Libero L., Giordano M., Manetta F., Maschio A., Argenziano G., Pizza A., Santini L.
VII Divisione di Chirurgia Generale Facoltà di Medicina e Chirurgia Seconda Università di Napoli, Napoli
We report a case of an hepatic adrenal rest tumor in a 29-year-old female patient who complained oligomenorrhea and clinical and biochemical data suggestive of hypercortisolism. Previously she had the diagnosis of an hepatic mass defined as emangioma at laparotomy. The cortex-adrenal scintigraphy revealed uptake in the area corresponding to the right adrenal gland; an ultrasound evaluation of abdomen showed a nodular hypoechoic structure of 7.1x6.1 mm in diameter between the VI and the VII hepatic segments; a computerized tomography of the abdomen described the lesion as an adrenal mass with extension into the liver parenchyma. A 18-FDG-positron emission tomography revealed an area of increased metabolism into the liver. At laparotomy the right adrenal gland was independent from the liver and showed no lesion. A yellowish-brown tumor measuring 60 mm was well circumscribed in the subcapsular portion of the right hepatic lobe and described as “adrenal rest tumor” at hystology. Functional adrenal rest tumor are rarely described in live. A periodic clinical and biochemical postoperative control of adrenal function has been necessary even if size changings of mass or relapses are documented at imaging studies.