Outwater E, Bankoff M S
Department of Radiology, New England Medical Center Hospital, Boston, Massachusetts 02111.
Clin Imaging. 1989 Sep;13(3):195-200. doi: 10.1016/0899-7071(89)90145-9.
Clinically significant adrenal hemorrhage due to adrenal metastases has rarely been reported. We describe three cases of this unusual entity, two from lung carcinoma and one from sarcoma. Adrenal hemorrhage was bilateral in two patients, and was the presenting manifestation of malignancy in two. A computed tomography diagnosis of hemorrhage within bilateral adrenal metastases was made when adrenal masses rapidly enlarged in one case, and when previously resolving hematomas showed enlargement in a second case. The third case was believed to represent a pheochromocytoma preoperatively. We conclude that significant adrenal hemorrhage can result from adrenal metastases and can be the presenting manifestation of metastatic tumor. In the patient without discernible risk factors for adrenal hemorrhage, underlying malignancy should be considered as a possible cause, even if the hemorrhage is bilateral.
因肾上腺转移瘤导致的具有临床意义的肾上腺出血鲜有报道。我们描述了三例这种不常见的情况，其中两例源于肺癌，一例源于肉瘤。两例患者的肾上腺出血为双侧性，且两例均以肾上腺出血作为恶性肿瘤的首发表现。在一例中，肾上腺肿块迅速增大，另一例中先前已消退的血肿出现增大，通过计算机断层扫描诊断为双侧肾上腺转移瘤内出血。第三例术前被认为是嗜铬细胞瘤。我们得出结论，显著的肾上腺出血可由肾上腺转移瘤引起，且可为转移性肿瘤的首发表现。对于无明显肾上腺出血危险因素的患者，即使出血为双侧性，也应考虑潜在恶性肿瘤为可能病因。
