Adrenal pseudo cyst presenting as retroperitoneal lesion: a rare presentation
DOI:
https://doi.org/10.18203/2349-2902.isj20233006Keywords:
Adrenal pseudocyst, Incidentalomas, Diagnosis, Retroperitoneal cystsAbstract
Adrenal pseudocyst are cystic lesions arising from the adrenal gland and do not contain any definitive epithelial lining. These are extremely rare and very few cases are reported, representing 1-2% of adrenal incidentalomas. Patients generally have a non-specific presentation with most patients being asymptomatic and detected incidentally, while others may present with the ensuing mass symptoms in cases of large cysts. Multiple differential diagnosis may be considered for the same. Here we reported the case of a 43 year old female who presented to us with worsening pain abdomen in the left upper quadrant. An ultrasonography revealed an 8×9×9 cm cystic lesion in the region of the tail of pancreas. Subsequent CT was suggestive of a retroperitoneal cyst with multiple diagnostic possibilities owing to the many intra-abdominal structures it was found to be associated with. A definitive pre-operative diagnosis regarding the origin of the cystic swelling could not be made. A decision to remove the lesion operatively via an open approach through an upper midline laparotomy was made and eventual histopathological diagnosis confirmed it to be an adrenal pseudocyst.
References
Calissendorff J, Juhlin CC, Sundin A, Bancos I, Falhammar H. Adrenal cysts: an emerging condition. Nat Rev Endocrinol. 2023;19(7):398-406.
Habra MA, Feig BW, Waguespack SG. Image in endocrinology: adrenal pseudocyst. J Clin Endocrinol Metab. 2005;90(5):3067-8.
Ujam AB, Peters CJ, Tadrous PJ, Webster JJ, Steer K, Martinez-Isla A. Adrenal pseudocyst: Diagnosis and laparoscopic management - A case report. Int J Surg Case Rep. 2011;2(8):306-8.
Wieneke JA, Thompson LDR. Non-neoplastic lesions of the adrenal gland. In: Thompson LDR, editor. Endocrine pathology. In: Goldblum JR, series eds. Foundations in diagnostic pathology. Philadelphia, PA: Churchill Livingstone Elsevier; 2006: 183-204.
Aloraifi F, O‘Brien G., Broe P. Giant adrenal pseudocyst treated laparoscopically: case report and review of the literature. Open Surg J. 2008;2:39-42.
Mahmodlou R, Valizadeh N. Spontaneous rupture and hemorrhage of adrenal pseudocyst presenting with acute abdomen and shock. Iran J Med Sci. 2011;36(4):311-4.
Demir A, Tanidir Y, Kaya H, Turkeri LN. A giant adrenal pseudocyst: case report and review of the literature. Int Urol Nephrol. 2006;38(1):167-9.
Wang LJ, Wong YC, Chen CJ, Chu SH. Imaging spectrum of adrenal pseudocysts on CT. Eur Radiol. 2003;13(3):531-5.
Kyoda Y, Tanaka T, Maeda T, Masumori N, Tsukamoto T. Adrenal hemorrhagic pseudocyst as the differential diagnosis of pheochromocytoma--a review of the clinical features in cases with radiographically diagnosed pheochromocytoma. J Endocrinol Invest. 2013;36(9):707-11.
Wedmid A, Palese M. Diagnosis and treatment of the adrenal cyst. Curr Urol Rep. 2010;11(1):44-50.
Porpiglia F, Fiori C, Daffara F, Zaggia B, Bollito E, Volante M, et al. Retrospective evaluation of the outcome of open versus laparoscopic adrenalectomy for stage I and II adrenocortical cancer. Eur Urol. 2010;57(5):873-8.
Yokoyama Y, Tajima Y, Matsuda I, Kamada K, Ikehara T, Uekusa T, et al. Differential diagnosis and laparoscopic resection of an adrenal pseudocyst: A case report. Int J Surg Case Rep. 2020;72:178-82.
