World Journal of Endocrine Surgery

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VOLUME 9 , ISSUE 1 ( January-April, 2017 ) > List of Articles


Adrenal Intravascular Papillary Endothelial Hyperplasia

Casey Holmes, Anwar Akhras, Andrew Schneider, Joseph H Yacoub, Maria Picken

Citation Information : Holmes C, Akhras A, Schneider A, Yacoub JH, Picken M. Adrenal Intravascular Papillary Endothelial Hyperplasia. World J Endoc Surg 2017; 9 (1):16-19.

DOI: 10.5005/jp-journals-10002-1201

Published Online: 01-08-2009

Copyright Statement:  Copyright © 2017; The Author(s).



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.


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.


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.

How to cite this article

Holmes C, Akhras A, Schneider A, Yacoub JH, Picken M, Kabaker A. Adrenal Intravascular Papillary Endothelial Hyperplasia. World J Endoc Surg 2017;9(1):16-19.

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  1. Intravascular papillary endothelial hyperplasia occurring within the thyroid gland: a rare event. Neurographics 2015 July 1;5(4):178-180.
  2. Intravascular papillary endothelial hyperplasia (Masson's Tumor) found as an adrenal incidentaloma. J Med Cases 2015;6(7)318-319.
  3. Primary benign vascular tumors and tumorlike lesions of the kidney: a clinicopathologic analysis of 15 cases. Virchows Arch. 2012 Dec;461(6):669-676.
  4. Papillary endothelial hyperplasia of the adrenal gland: report of a case and review of the literature. Am Surg 2008 Sep;74(9):813-816.
  5. Masson's “vegetant intravascular hemangioendothelioma:” a lesion often mistaken for angiosarcoma: study of seventeen cases located in the skin and soft tissues. Cancer 1976 Sep;38(3):1227-1236.
  6. Intravascular papillary endothelial hyperplasia of renal vein: report of 2 cases. Arch Pathol Lab Med 2005 Apr;129(4):516-519.
  7. Adrenal incidentaloma. Best Pract Res Clin Endocrinol Metab 2012 Aug;26(4):405-419.
  8. Cross-sectional imaging work-up of adrenal masses. World J Radiol 2013 Mar;5(3):88-97.
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