case_images: PMC5722048_01
case_images: Plain CT prior to AVS. CT detected an adrenal mass 1.4 cm in diameter (arrows).
case_images: jocmr-10-066-g001.jpg
case_images: PMC5722048_01_jocmr-10-066-g001.jpg
case_images: F1
case_images: At the age of 56 years, ultrasound identified a right adrenal mass during a routine medical check-up and CT confirmed a 1.4 cm adrenal mass (Fig. 1).
case_images: Fluoroscopy images immediately after AVS. Left: LAO90, CRA0; right: RAO90, CRA0. The patient complained of chest discomfort and back pain after AVS, and pooling of contrast medium was noted at that time in the entire right adrenal gland (dotted circle).
case_images: jocmr-10-066-g002.jpg
case_images: PMC5722048_01_jocmr-10-066-g002.jpg
case_images: F2
case_images: Plain CT after AVS. Immediately after AVS, pooling of contrast medium in the entire right adrenal gland was observed (arrow).
case_images: jocmr-10-066-g003.jpg
case_images: PMC5722048_01_jocmr-10-066-g003.jpg
case_images: F3
case_images: AVS revealed a hematoma and pooling of contrast medium in the right adrenal gland (Fig. 3). Although chest and back pain continued, the ECG and laboratory findings ruled out myocardial ischemia.
case_images: Results of AVS. Blood sampling site numbers are in parentheses. Plasma aldosterone concentration (pg/mL)/plasma renin activity (ng/mL/h) = aldosterone-renin ratio.
case_images: jocmr-10-066-g004.jpg
case_images: PMC5722048_01_jocmr-10-066-g004.jpg
case_images: F4
case_images: The results of AVS at 15 sites are shown in Figure 4.
case_images: Plain CT at 60 days after AVS. The hematoma is smaller, but the adrenal gland is slightly enlarged (arrows).
case_images: jocmr-10-066-g005.jpg
case_images: PMC5722048_01_jocmr-10-066-g005.jpg
case_images: F5
case_images: The right adrenal gland hematoma was followed up by CT for 60 days (Fig. 5).
case_images: Cut surfaces of the resected right adrenal gland. The adrenal gland shows focal necrosis and hemorrhage cystic change, probably due to AVS.
case_images: jocmr-10-066-g006.jpg
case_images: PMC5722048_01_jocmr-10-066-g006.jpg
case_images: F6
case_images: Pathological examination of the resected adrenal gland showed that the tumor was heterogeneous, ranging from large lipid-rich cells to smaller cells with relatively little lipid and cells with compact eosinophilic cytoplasm (Fig. 6).