A woman with a suprarenal mass and hypertension

doi:10.1136/bmj.b333

Published 4 March 2009, doi:10.1136/bmj.b333
Cite this as: BMJ 2009;338:b333

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A woman with a suprarenal mass and hypertension

H Kahal, specialist trainee 3 in diabetes and endocrinology, E Cooper, foundation year 2, R Sriraman, specialist registrar in general medicine, diabetes, and endocrinology, D V Coppini, consultant physician, honorary senior lecturer in diabetes and endocrinology

¹ Department of Diabetes and Endocrinology, Poole Hospital NHS Foundation Trust, Poole BH15 2JB

Correspondence to: H Kahal hassoon011@yahoo.com

The first 150 words of the full text of this article appear below.

A woman presented to surgeons with abdominal discomfort in 1990.She underwent abdominal computed tomography, which showed alarge incidental right suprarenal mass (fig 1). Follow-up scanssuggested a benign stable adenoma, measuring 49x60 mm, and thedecision was made not to operate. An endocrine opinion was notsought. Her medical history included hypertension.

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Fig 1 Abdominal computed tomography scan showing a suprarenal mass (arrow)

In June 2006, at the age of 69, she re-presented with peritonitis,and a laparotomy showed a thickened wall cyst at the duodeno-jejunaljunction. During elective excision of the cyst in April 2007,it was difficult to achieve haemodynamic stability. An unplannedresection of the suprarenal mass was performed concomitantly.The cyst stained strongly positive for CD117. Figure 2

showsthe patient’s clinical features.