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

Introduction: Adrenal hemangiomas are rare benign vascular tumors of the adrenal gland and are most often discovered incidentally during imaging studies performed for unrelated conditions. Case presentation: 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-h 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. Conclusion: Adrenal masses of unknown etiology that show a progression in size should be surgically removed.