CASE REPORT   

Journal of Radiological Review 2020 March-April;7(2):144-6

DOI: 10.23736/S2723-9284.20.00234-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English, Italian

“Vessel sign” in a case of adrenal adenoma

Antonio LO CASTO ¹, Manfredi AGNESE ¹ ✉, Pierpaolo PURPURA ²

¹ Section of Radiologic Sciences, BIND Department, University of Palermo, Palermo, Italy; ² Foundation Institute Hsr G. Giglio, Cefalù, Palermo, Italy

Vessel sign consists of a venous vessel that passes through an adrenal lesion, typically the adenoma, visible with computed tomography (CT) with intravenous contrast medium. The venous vessel (the central adrenal vein) usually originates on the right directly from the inferior vena cava and on the left from the left renal vein. Adenoma is a benign lesion found with relative frequency and is often a proper incidentaloma. Among the features that allow differential diagnosis between adenoma and other adrenal lesions on CT, the “vessel sign” can be of great help. The sign is not present in many adenomas but can be found more frequently in the larger ones and with greater adipose content. In literature there are very few studies on the “vessel sign” and we have found two: one supports the absolute specificity of the aforementioned sign, not found in other benign (as myelolipoma) or malignant (as metastases or adenocarcinoma) adrenal lesions; in the other study the authors do not agree on the specificity of the “vessel sign”, called by them “central feeding vessel”, as they describe the sign also in secondary adrenal lesions. This paper describes a case of adrenal adenoma, in which it was observed on enhanced CT the “vessel sign”, a sign probably unknown to many radiologists but worthy of attention, because of the high specificity for adenoma, although in the literature there are conflicting opinions.

KEY WORDS: Adrenocortical adenoma; Tomography, X-ray computed; Adrenal glands