Gastric diverticulum simulating left adrenal incidentaloma in a hypertensive patient

Ryo Kodera, Fumio Otsuka, Kenichi Inagaki, Tomoko Miyoshi, Toshio Ogura, Yasushi Tanimoto, Tetsuro Sei, Hirofumi Makino

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

A 46-year-old Japanese male with hypertension was referred for examination of left adrenal tumor incidentally detected by computed tomography (CT) scan. The patient had a 4-month history of hypertension. Abdominal CT demonstrated a low-density mass 2.5 cm in diameter in the left adrenal region that was observed as a high-intense lesion with T2-weighted magnetic resonance imaging. 131I-adosterol scintigraphy showed normal uptake of bilateral adrenals. The adrenocortical hormone levels were within normal ranges; however, urinary noradrenaline excretion was slightly elevated, likely due to concurrent sleep apnea syndrome. Based on the observation of a very tiny bubble in the ventral portion of the adrenal mass by careful review of CT images examined at a previous hospital, a restudy of abdominal CT with oral contrast was performed. In this restudy abdominal CT we observed positive enhancement of the left adrenal mass, indicating that the adrenal mass was a diverticulum derived from posterior gastric fornix. The present case study reinforces that preoperative differentiation from mimic adrenal tumors is necessary in cases of cystic adrenal mass in the left adrenal region.

Original languageEnglish
Pages (from-to)969-974
Number of pages6
JournalEndocrine journal
Volume54
Issue number6
DOIs
Publication statusPublished - 2007

Keywords

  • Adrenal incidentaloma
  • Gastric diverticulum
  • Left adrenal tumor
  • Pseudoadrenal tumor
  • Sleep apnea syndrome

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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