Pseudocyst of adrenal gland. Case report

Main Article Content

Carlos Ignacio Rafael-Pérez http://orcid.org/0000-0001-9695-9803
Alexis Jared Paz-López http://orcid.org/0009-0003-3410-3526
Neri Ruvalcaba-Contreras http://orcid.org/0000-0001-5434-523X

Keywords

Adrenalectomy, Laparotomy, Cysts, Adrenal Glands

Abstract

Background: Adrenal gland cysts are a rare entity, with a reported incidence in post-mortem series of 0.06-0.18%. However, the incidence seems to be increasing in recent years. The presentation of adrenal gland cysts is usually asymptomatic, but those cases in which symptoms are present are usually non-specific, which makes adrenal cysts generally recognized as incidentalomas. The finding is mainly made by computed tomography. The main objective of this article was to describe the clinical course of a patient with an adrenal gland pseudocyst, which is accompanied by symptoms of compression and persistent pain of long evolution in the left flank.


Clinical case: A 65-year-old female patient attended the emergency room of a second-level hospital due to an increase in volume of the abdominal region with a sensation of fullness, heartburn, vomiting and pain. Computed tomography was performed, which reported a cystic mass and, later, exploratory laparotomy plus adrenalectomy were carried out. The pathology analysis reported a diagnosis of a 10 x 15 x 14 cm solid, cystic, and adherent tumor, coinciding with a pseudocyst of the adrenal gland.


Conclusions: Adrenal gland cysts are rare. Computed tomography is recommended for its diagnosis and the standard of treatment is surgical intervention in the presence of symptoms.

Abstract 47 | PDF (Spanish) Downloads 23

References

Dogra P, Rivera M, McKenzie TJ, et al. Clinical course and imaging characteristics of benign adrenal cysts: a single-center study of 92 patients. Eur J Endocrinol. 2022;187(3):429-37. doi: 10.1530/EJE-22-0285.

Dogra P, Sundin A, Juhlin CC, et al. Rare benign adrenal lesions. Eur J Endocrinol. 2023;188(4):407-20. doi: 10.1093/ejendo/lvad036.

Solanki S, Badwal S, Nundy S, et al. Cystic lesions of the adrenal gland. BMJ Case Rep. 2023;16(5):e254535. doi: 10.1136/bcr-2022-254535.

Gubbiotti MA, LiVolsi V, Montone K, et al. A Cyst-ematic Analysis of the Adrenal Gland: A Compilation of Primary Cystic Lesions From Our Institution and Review of the Literature. Am J Clin Pathol. 2022;157(4):531-9. doi: 10.1093/ajcp/aqab156.

Wu MJ, Shih MH, Chen CL, et al. A 15-Year Change of an Adrenal Endothelial Cyst. Am J Case Rep. 2022;23:e935053. doi:10.12659/AJCR.935053.

Babaya N, Okuda Y, Noso S, et al. A Rare Case of Adrenal Cysts Associated With Bilateral Incidentalomas and Diffuse Hyperplasia of the Zona Glomerulosa. J Endocr Soc. 2020;5(2):bvaa184. doi: 10.1210/jendso/bvaa184.

Olakowski M, Ciosek J. Giant pseudocyst of the retroperitoneal space mimicking a lesion arising from the left adrenal gland. Endokrynol Pol. 2022;73(4):790-1. doi: 10.5603/EP.a2022.0039.

Bramhe S, Dhawan S, Dhamija N. An unusual case of ectopic thyroid tissue in an adrenal gland presenting as a cyst. Indian J Cancer. 2021;58(2):294-5. doi: 10.4103/ijc.IJC_181_20.

Kumar S, Parmar KM, Aggarwal D, et al. Simple adrenal cyst masquerading clinically silent giant cystic pheochromocytoma. BMJ Case Rep. 2019;12(9):e230730. doi: 10.1136/bcr-2019-230730.

Cortés-Vázquez YD, Mejía-Ríos LC, Priego-Niño A, et al . Carcinoma corticoadrenal, reporte de caso. Cir Cir. 2021; 89(5): 664-8. doi: 10.24875/ciru.20000693.

Jiménez RW, Mosquera M, Moreno K, et al. Manejo quirúrgico del quiste adrenal gigante: Reporte de caso y revisión de la literatura. Rev Cir. 2019;71(2):162-7. doi: 10.4067/s2452-45492019000200162.

Bancos I, Prete A. Approach to the Patient With Adrenal Incidentaloma. J Clin Endocrinol Metab. 2021;106(11):3331-53. doi: 10.1210/clinem/dgab512.

Goel D, Enny L, Rana C, et al. Cystic adrenal lesions: A report of five cases. Cancer Rep (Hoboken). 2021;4(1):e1314. doi: 10.1002/cnr2.1314.

Kloos RT, Gross MD, Francis IR, et al. Incidentally discovered adrenal masses. Endocr Rev. 1995;16(4):460-84. doi: 10.1210/edrv-16-4-460.

Zivković SM, Jancić-Zguricas M, Jokanović R, et al. Adrenal cysts in the newborn. J Urol. 1983;129(5):1031-3. doi: 10.1016/s0022-5347(17)52528-8.

Karaosmanoglu AD, Onder O, Leblebici CB, et al. Cross-sectional imaging features of unusual adrenal lesions: a radiopathological correlation. Abdom Radiol (NY). 2021;46(8):3974-94. doi: 10.1007/s00261-021-03041-8.

Wedmid A, Palese M. Diagnosis and treatment of the adrenal cyst. Curr Urol Rep. 2010;11(1):44-50. doi: 10.1007/s11934-009-0080-1.

Poiana C, Carsote M, Chirita C, et al. Giant adrenal cyst: case study. J Med Life. 2010;3(3):308-13.

Feltes S, Delgado M, Duarte D, et al. Suprarrenalectomia derecha videolaparoscópica transperitoneal por Síndromede Conn. Cir Parag. 2019;43(3):34-5. doi: 10.18004/sopaci.2019.diciembre.34-35.

Styopushkin SP, Chaikovskyi VP, Chernylovskyi VA, et al. Partial artial laparoscopic adrenalectomy – Anatomical basis and operation technique. Wiad Lek. 2020;73(9 cz. 2):1977-81.

Mete O, Erickson LA, Juhlin CC, et al. Overview of the 2022 WHO Classification of Adrenal Cortical Tumors. Endocr Pathol. 2022;33(1):155-96. doi:10.1007/s12022-022-09710-8.

Ito J, Kaiho Y, Kusumoto H, et al. Use of the SAND balloon catheter for safe and easy laparoscopic removal of adrenal cysts. IJU Case Rep. 2021;4(6):371-4. doi: 10.1002/iju5.12352.