Gastric Diverticulum Simulating Left Adrenal Incidentaloma in a Hypertensive Patient

• KODERA Ryo

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OTSUKA Fumio

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• INAGAKI Kenichi

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• MIYOSHI Tomoko

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OGURA Toshio

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• TANIMOTO Yasushi

  Department of Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• SEI Tetsuro

  Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• MAKINO Hirofumi

  Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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. ¹³¹ I-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.<br>

Journal

• Endocrine Journal

  Endocrine Journal 54 (6), 969-974, 2007

  The Japan Endocrine Society

Keywords

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

Details

• CRID: 1390001206299058048
• NII Article ID: 10021263958
• NII Article ID: 130004443349
• NII Book ID: AA10901436
• DOI: 10.1507/endocrj.k07e-025
• ISSN: 13484540
• ISSN: 09188959
• Web Site: http://www.jstage.jst.go.jp/article/endocrj/54/6/54_K07E-025/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008213599
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed