Large Pseudocyst of the Adrenal Gland: A Radiological Pathological Correlation

Abstract

Cystic lesion of adrenal gland is an uncommon entity and many are found incidentally. Large adrenal cysts can sometimes found to be associated with abdominal discomfort. These entities can also be associated with hemorrhage, rupture or infection. Adrenal pseudo cysts can be a squeal of hemorrhage or trauma within an adrenal gland and can expand to a massive size due to gross fluid accumulations. We report a case of a 35-year-old male who presented with bloating of abdomen and cosmetic concern due to the increase in size of the abdominal girth. On plain radiograph and gastrograffin study of abdomen the lesion appeared as a soft tissue opacity displacing the normal structures away from it. On ultrasound abdomen, lesion appeared as a large cyst of indeterminate origin. The CECT scan revealed it as a hypodense cystic lesion with a well defined wall and showed hypodense contents of 15 HU densities. The lesion was displacing medial limb of the left adrenal, small, large bowel loops, left kidney and pancreas away from it. The complete excision tried by laparoscopy however converted to the open excision as the mass was attached to the left adrenal gland to its lateral aspect. The histopathological diagnosis confirmed it is an adrenal pseudocyst.

Keywords

• Calcification
• Malignancy
• Radiograph