Purpose: We report and discuss the imaging features of 8 cases of spontaneous unilateral adrenal hematomas, a rare lesion.
Materials and methods: Computerized tomography (CT) was done in 8 cases, magnetic resonance imaging (MRI) in 5, and CT and MRI in 5. Imaging findings were reviewed and correlated with histological findings in all 8 cases.
Results: MRI was the most accurate imaging modality and showed variable appearances. On pathological evaluation the hematomas were old and organized. No contrast enhancement was noted on CT or MRI.
Conclusions: One must not consider the diagnosis of spontaneous adrenal hematoma only as superimposed on a phechromocytoma or malignant lesion in the case of an incidentally discovered large adrenal mass with normal biological findings. MRI signs of adrenal hemorrhage and the failure of enhancement of such a mass should strongly suggest adrenal hematoma.