SAT345 Disappearing Adrenal Masses: A Tale Of Two Lesions

Disclosure: A. arooj: None. A. Lansdown: None. Introduction: Adrenal lesions are being increasingly detected on CT scans performed for other reasons. Adrenal lesions that “disappear” on subsequent imaging are rare, most commonly due to adrenal hematomas, cysts or infection. Case: 1 73-year-old man was admitted with a collapse and fall. CT head & angiogram demonstrated cerebral sinus thrombosis, subarachnoid hemorrhage and right parietal hematoma. Furthermore, high density4cm left adrenal lesion on CT abdomen(Fig 1) Consideration was given to COVID vaccine induced thrombotic thrombocytopenia. ACTH, aldosterone, renin, aldosterone renin ratio normal. Slightly low cortisol (386) after short synacthen test. Later, CT showed the left adrenal lesion had disappeared in Fig 2. Case 2: 36-year-old man following a road traffic collision, fell from his electric scooter at a speed of 30mph, also noted to have high blood pressure on admission. He had small laceration of the liver which was managed conservatively. CT abdomen and pelvis, showed a low density 28mm right adrenal nodule, measuring 37 Hounsfield Units,(fig 3) that was completely resolved in subsequent imaging (Fig4). His biochemistry reports of dexamethasone suppression test, renin, aldosterone, 24hr metadrenaline urinary profile and urinary cortisol remained normal. Learning points: "Disappearing", adrenal mass lesions are rare, though reported, and most commonly due to adrenal hematomas, cysts or infection. References: I G Hermsen , M P J Polak, H R Haak. Disappearing adrenal masses. Endocrine. 2010 Oct;38(2):153-7. doi: 10.1007/s12020-010-9368-7. Epub 2010 Jul 11, Presentation: Saturday, June 17, 2023