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JAMA Surgery Clinical Challenge
June 2015

A Large, Symptomatic, Left Adrenal Mass

Author Affiliations
  • 1Department of Surgery, Saint Agnes Hospital, Baltimore, Maryland
JAMA Surg. 2015;150(6):591-592. doi:10.1001/jamasurg.2015.0242

A man in his 40s presented with sudden left-sided abdominal pain that was sharp, severe, and associated with emesis. He denied fevers, dizziness, or recent trauma. He had no notable medical or surgical history. He was afebrile with normal vital signs. He was well nourished, alert, and in no acute distress. Results of an abdominal examination revealed normoactive bowel sounds, no distention, but tenderness on the left side. Computed tomography (CT) of the abdomen and pelvis with intravenous contrast revealed a 12 × 13 × 11-cm left-sided adrenal mass (Figure 1). Results of laboratory examination revealed plasma levels of metanephrines, normetanephrines, cortisol, renin, and aldosterone within reference limits.

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