The patient is a 57-year-old woman who had a known left adrenal mass, which likely was related to a previous episode of bleeding (hemorrhage). Bleeding in a normal adrenal gland or a pre-existing tumor can be problematic. As the area heals, it sometimes forms a peripherally calcified mass, meaning, there is calcification formed at the outer layer of the adrenal mass. The mass occasionally bothered her with pain in the area. The patient’s laboratory investigation was normal, except for low cortisol levels. However, she had chronically been maintained on hydrocortisone for cervical disc disease, which explained this.

The tricky thing with adrenal tumors containing calcifications is that we can see this in both benign and cancerous cases. Adrenal cortical adenomas, adrenal carcinomas, previous adrenal hemorrhage, adrenal metastases, pheochromocytomas, and some infectious processes of the adrenal all can manifest as a calcified mass

She underwent a CT scan, which is what you are viewing in this video.

To read more about imaging, and best X-ray studies of adrenal tumors go here: https://www.adrenal.com/adrenal-tumor...

Reviewing the CT scan made me quite confident that this was a not cancerous. However, when these masses are symptomatic (as in our patient’s case) they need to be removed by surgery.

The patient was an excellent candidate for the mini back scope adrenalectomy (MBSA), and did tremendously well after the operation.

Next, she will work with her endocrinologist to wean off her hydrocortisone. Unfortunately, she was placed on steroid for her cervical disc disease, and now her right adrenal gland (the one remaining) is iatrogenically suppressed by long term steroid use. Over time it will wake up, but it may take several months. Don’t stay on steroids longer than you absolutely have to…

Read about mini back scope adrenalectomy (MBSA) here:
https://www.adrenal.com/adrenal-surge...

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