Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study

Situs anomalies, including situs inversus and situs ambiguous (SAMB), are rare congenital conditions typically noted in pediatric populations, with SAMB being particularly uncommon in adults. This case study addresses the incidental discovery of situs ambiguous with polysplenia in a 65-year-old man...

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Main Authors: Pavel E. Stanchev, Mariya Dimitrova, Desislava Makakova, Boris Tilov
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/60/12/2010
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author Pavel E. Stanchev
Mariya Dimitrova
Desislava Makakova
Boris Tilov
author_facet Pavel E. Stanchev
Mariya Dimitrova
Desislava Makakova
Boris Tilov
author_sort Pavel E. Stanchev
collection DOAJ
description Situs anomalies, including situs inversus and situs ambiguous (SAMB), are rare congenital conditions typically noted in pediatric populations, with SAMB being particularly uncommon in adults. This case study addresses the incidental discovery of situs ambiguous with polysplenia in a 65-year-old man evaluated for suspected adrenal adenoma. The patient’s medical history included benign prostatic hyperplasia and tuberculous pleurisy. Methods included a thorough physical examination and laboratory tests, which showed normal cortisol levels and ACTH rhythm. Contrast-enhanced CT imaging revealed multiple spleens near the right adrenal region, altered liver positioning, a truncated pancreas, and a right-sided stomach, while the right adrenal gland was not visualized. Notably, the patient exhibited minimal symptoms despite these significant anatomical anomalies. The findings underscore the rarity of situs ambiguous in adults and its unexpected association with endocrine pathology. This case highlights the importance of comprehensive imaging and a multidisciplinary approach in managing patients with unusual anatomical presentations. It suggests that situs anomalies may be more prevalent in adult populations than previously recognized and emphasizes the need for increased clinical awareness and evaluation in similar cases.
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spelling doaj-art-e97948d03e624d5ba41c42feb05df9812025-08-20T02:56:56ZengMDPI AGMedicina1010-660X1648-91442024-12-016012201010.3390/medicina60122010Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case StudyPavel E. Stanchev0Mariya Dimitrova1Desislava Makakova2Boris Tilov3Clinic of Endocrinology and Metabolic Diseases, St. George University Hospital, Medical University of Plovdiv, 4002 Plovdiv, BulgariaDepartment of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaDepartment of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4002 Plovdiv, BulgariaMedical College, Medical University of Plovdiv, 4002 Plovdiv, BulgariaSitus anomalies, including situs inversus and situs ambiguous (SAMB), are rare congenital conditions typically noted in pediatric populations, with SAMB being particularly uncommon in adults. This case study addresses the incidental discovery of situs ambiguous with polysplenia in a 65-year-old man evaluated for suspected adrenal adenoma. The patient’s medical history included benign prostatic hyperplasia and tuberculous pleurisy. Methods included a thorough physical examination and laboratory tests, which showed normal cortisol levels and ACTH rhythm. Contrast-enhanced CT imaging revealed multiple spleens near the right adrenal region, altered liver positioning, a truncated pancreas, and a right-sided stomach, while the right adrenal gland was not visualized. Notably, the patient exhibited minimal symptoms despite these significant anatomical anomalies. The findings underscore the rarity of situs ambiguous in adults and its unexpected association with endocrine pathology. This case highlights the importance of comprehensive imaging and a multidisciplinary approach in managing patients with unusual anatomical presentations. It suggests that situs anomalies may be more prevalent in adult populations than previously recognized and emphasizes the need for increased clinical awareness and evaluation in similar cases.https://www.mdpi.com/1648-9144/60/12/2010situs ambiguouspolyspleniaadrenal adenomacongenital anomaliesendocrinologyadult situs inversus
spellingShingle Pavel E. Stanchev
Mariya Dimitrova
Desislava Makakova
Boris Tilov
Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study
Medicina
situs ambiguous
polysplenia
adrenal adenoma
congenital anomalies
endocrinology
adult situs inversus
title Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study
title_full Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study
title_fullStr Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study
title_full_unstemmed Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study
title_short Exploring the Differential Diagnosis of Adrenal Adenoma in the Context of Situs Ambiguous: A Clinical Case Study
title_sort exploring the differential diagnosis of adrenal adenoma in the context of situs ambiguous a clinical case study
topic situs ambiguous
polysplenia
adrenal adenoma
congenital anomalies
endocrinology
adult situs inversus
url https://www.mdpi.com/1648-9144/60/12/2010
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AT desislavamakakova exploringthedifferentialdiagnosisofadrenaladenomainthecontextofsitusambiguousaclinicalcasestudy
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