Solid adrenal mass: not always what it seems

Other cystic pathologies are congenital epithelial cysts associated with Beckwith Wiedemann syndrome and Prune belly syndrome, parasitic infec- tions, and cystic neuroblastoma.1 Solid adrenal masses have a more narrow differential diagnosis including neuroblastoma, pheochromocytoma, and adrenocortical tumors.1 Although adrenocortical tumors in adults are fairly common, the likelihood of adrenal cancer is low. In one study of 1155 children who sustained blunt ab- dominal trauma, only three per cent of children had adrenal hemorrhage seen on CT with the majority of trauma resulting from motor vehicle accidents and assault.3 In that cohort, adrenal hemorrhage was as- sociated with ipsilateral solid organ injury in 61 per cent of the patients and ipsilateral chest injury in 44 per cent of the patients.