What's the most likely diagnosis?

• 59 year-old male with change in bowel habits

1. Carcinoma of the colon
2. Bilateral renal calculi
3. Cirrhosis
4. Myelolipomas
5. Bilateral adrenal calcifications

Answer:

 

5. Bilateral Adrenal Calcifications

 

 

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Adrenal calcifications

General Considerations

• Hemorrhage is the most common cause
• Generally, patients with non-traumatic adrenal hemorrhage are critically ill and have a coagulopathy
• Adrenal glands are proportionately larger in neonates than adults and prone to complications from hypoxia or hypotension
• Unilateral 80% of time and involves right side 85% of time
• Unilateral adrenal hemorrhage rarely produces clinical findings
  • In adults, it is frequently found incidentally in trauma
• Most (90%) of adrenal tissue must be destroyed for adrenal insufficiency
• Adrenal hemorrhage is prognostically important because it may signify severe stress or unsuspected coagulopathy

 

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