Adrenal intravascular papillary endothelial hyperplasia

Aim: We describe the rare case of a woman with adrenal intravascular papillary endothelial hyperplasia (IPEH) or Masson’s tumor. We present relevant background information on IPEH and our case report, as well as describe a workup and treatment plan for the lesion. Introduction: Intravascular papillary endothelial hyperplasia (IPEH) or Masson’s tumor is a rare lesion, i.e., predominantly found in the oral cavity, head, and neck.^1-4 To our knowledge, only six adrenal IPEH cases have been reported in the literature to date.⁴ Case report: A 49-year-old woman originally presented to us with an incidentaloma found on computed tomography scan. Due to the eventual size increase of the mass, a laparoscopic left adrenalectomy was performed. Pathologic evaluation of the mass revealed a 3 cm IPEH arising in a hemangioma within the adrenal gland. Conclusion: Before the diagnosis of IPEH is considered as the etiology for an adrenal incidentaloma, it is crucial to rule out more common tumors. Serological and radiographic studies are critical to the workup. Clinical Significance: The IPEH is a very interesting lesion of the adrenal gland, however, it is exceedingly rare and thus exclusion of more common and serious lesions must be done prior to the diagnosis of IPEH.