Adrenal hemangioma in an 8-year-old girl: a case report

Adrenal hemangiomas are rare benign vascular tumors of the adrenal gland and are most often discovered incidentally during imaging studies performed for unrelated conditions. We report the case of adrenal hemangioma in an 8-year-old girl with hereditary spherocytosis (Minkowski–Chauffard disease) who was evaluated for symptomatic splenomegaly prior to planned splenectomy. During preoperative assessment, an abdominal computed tomography (CT) scan incidentally revealed a 14-mm well-defined lesion in the left adrenal gland. Magnetic resonance imaging (MRI) was subsequently performed for further characterization and demonstrated a well-circumscribed adrenal mass with homogeneous T1 hypointensity and heterogeneous T2 hyperintensity with peripheral enhancement, raising suspicion for malignancy such as adrenocortical carcinoma or pheochromocytoma. Follow-up CT imaging three months later showed interval growth to 24 mm. Hormonal evaluation, including 24-hour urinary catecholamines and their metabolites, was within normal limits. Fluorodopa positron emission tomography (PET-CT) showed no increased metabolic activity. Due to its progressive growth and uncertain diagnosis, robotic-assisted laparoscopic adrenalectomy was performed. Histopathological examination established the diagnosis of a capillary hemangioma, characterized by proliferating small vascular channels lined with a single layer of endothelial cells. The postoperative course was uneventful, and the patient remains disease-free one year after surgery, with no radiological evidence of recurrence Adrenal masses of unknown etiology that show a progression in size should be surgically removed.