Evidence map›Paper›PMID 39825193›Full record

SynthesisEndocrine2025

The diagnostic dilemma of adrenal vascular tumors: analysis of 21 cases and systematic review of the literature.

Kimberly Coscia, Caterina Ravaioli, Lorenzo Tucci, Giacomo Colombin, Francesca Donnarumma, Cristina Mosconi, Caterina Balacchi, Cristina Nanni, Laura Alberici, Saverio Selva and 6 more

Abstract readSystematic Review
In one paragraph

Synthesis in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Kimberly CosciaDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Caterina RavaioliAnatomic Pathology - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Lorenzo TucciDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Giacomo ColombinDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Francesca DonnarummaDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Cristina MosconiDepartment of Specialized, Radiology Unit, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Caterina BalacchiDepartment of Specialized, Radiology Unit, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Cristina NanniNuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Laura AlbericiDivision of Pancreatic and Endocrine Surgical Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Saverio SelvaDivision of Pancreatic and Endocrine Surgical Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Uberto PagottoDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Donatella SantiniAnatomic Pathology - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Giovanni TalliniAnatomic Pathology - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Guido Di DalmaziDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Valentina VicennatiDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. valentina.vicennati2@unibo.it.
Antonio De LeoAnatomic Pathology - Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAdrenal vascular tumors are mainly represented by adrenal cavernous hemangiomas (ACHs) and adrenal cystic lymphangiomas (ACLs). Their radiological features often overlap with malignant tumors, therefore ruling out malignancy becomes mandatory. We analyzed clinical, radiological, and histopathological data to identify specific characteristics of these tumors.

methodsWe reviewed 21 patients with ACHs (n = 12), ACLs (n = 8), or adrenal cysts (n = 1) confirmed by histopathology. We selected 82 papers from PubMed to provide a systematic review of the literature.

resultsIn our cohort, median age at diagnosis was 58 years, with sex evenly distributed. All tumors were unilateral (median size = 44 mm), with 6 cases of increasing tumor size. All tumors exhibited non-contrast CT density > 10 Hounsfield Unit (HU). Calcifications were found in 5 cases. Hormonal studies revealed 11 non-functioning tumors and 2 cortisol-secreting tumors. Elevated urinary metanephrines were found in 2 cases. Immunostaining showed CD31/CD34/factor VIII expression in ACHs (n = 5, 24%) and podoplanin expression in ACLs (n = 6, 29%). The literature review revealed 71 reported cases of ACHs and 104 reported cases of ACLs. Median age at diagnosis was 46 years, with slightly female prevalence (63%). Median tumor size was 48 mm. 84 cases were symptomatic, with life-threatening hemorrhage reported in only 3 patients. Calcifications were found in 23% of cases. Surgical approaches varied, with open and laparoscopic adrenalectomy performed in 55 and 42 patients respectively.

conclusionsACHs and ACLs represent a diagnostic dilemma in clinical practice due to their rarity and their misleading imaging features.

Indexed as

Adrenal Gland NeoplasmsHemangioma, CavernousLymphangioma, CysticAdultAgedDiagnosis, DifferentialFemaleHumansMaleMiddle AgedAdrenal endothelial cystsAdrenal hemangiomasAdrenal lymphangiomas.Adrenal tumors

Identifiers

PMID39825193
PMCPMC11845438

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.