The Surgery Journal (Jan 2022)

Giant Adrenal Pseudocysts: An Enigma for Surgeons

  • Kunal Parasar,
  • Shantam Mohan,
  • Aaron George John,
  • Jitendra Nigam,
  • Utpal Anand,
  • Chandan Kumar Jha

DOI
https://doi.org/10.1055/s-0042-1744153
Journal volume & issue
Vol. 08, no. 01
pp. e112 – e116

Abstract

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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.

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