Giant Adrenal Pseudocysts: An Enigma for Surgeons

Surg J (N Y). 2022 Mar 3;8(1):e112-e116. doi: 10.1055/s-0042-1744153. eCollection 2022 Jan.

Abstract

Adrenal pseudocysts are cystic lesions arising within the adrenal gland enclosed by a fibrous connective tissue wall that lacks lining cells. They can attain a huge size and pose a diagnostic challenge with a broad range of differentials including benign and malignant neoplasms. There are only a few small case series and case reports describing these lesions. We report a series of five patients who presented with "indeterminate" abdominal cystic lesions and were later on found to have adrenal pseudocyst. Four out of five patients presented with non-specific abdominal symptoms, and one patient presented with symptoms suggestive of a functional adrenal tumor. The size of these tumors ranged from 6 to 30 cm. They had variable radiological features and in two cases even a percutaneous biopsy could not establish the diagnosis. In four of these "indeterminate" abdominal masses, an adrenal origin was not suspected preoperatively. Surgical excision provided a resolution of symptoms, ruled out malignancy, and clinched the diagnosis.

Keywords: abdominal mass; adrenal gland; adrenal pseudocyst; neoplasms.

Publication types

  • Case Reports

Grants and funding

Funding None.