貧血の精査中に発見された副腎血腫

A case of adrenal hematoma

　症例は68歳，女性。内科にて貧血の精査中に左副腎部の腫瘤を指摘された。造影CT，MRIにて左副腎部に辺縁と内部が不均一に染まる5cm大の球形の腫瘤を認めた。内分泌学的検査ではACTHが低値であったが，それ以外は正常であった。腫瘍性病変も否定できず，左副腎摘除術が施行された。病理組織像は，器質化された血栓を伴う副腎血腫であった。検索し得た限りでは自験例は突発性副腎血腫の成人例としては本邦16例目であった。

A left adrenal tumor was discovered incidentally on computerized tomography（CT）in a 68-year-old woman. She was referred to our hospital for further examination and treatment of adrenal tumor. The hormonal levels in blood and urine were normal except for low ACTH. CT and magnetic resonance imaging（MRI）showed a left adrenal tumor,5cm×5cm in size. CT was heterogeneously enhanced by the contrast medium. A peripheral rim of the mass was enhanced on dynamic MRI. The patient underwent adrenalectomy. Histopathological examination revealed adrenal hematoma which is a rare disease in adults. Including our case,16 such cases have been described in Japanese literature.