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      A rare case of a giant haemorrhagic adrenal cyst

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      Author(s): , ,
      Publication date (Electronic):
      Journal: Journal of Surgical Case Reports
      Publisher: JSCR Publishing Ltd

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          Abstract

          Giant adrenal cysts are an infrequent encounter in surgical practice. In this article we discuss a case of a 66 year old woman who presented with increasing abdominal girth and was subsequently found to have a large retroperitoneal mass on computed tomography (CT) scan. After a thorough endocrine work up was completed, the patient underwent an exploratory laparotomy with resection of a giant adrenal mass. This was ultimately found to be a haemorrhagic cyst. This case highlights the clinical features and management of this relatively rare finding.

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          Management of adrenal cysts.

          Stephanie Nance, Anita L Neri (1999)
          Adrenal cysts have been traditionally managed by excision to rule out malignancy. We reviewed the 613 cases of adrenal cysts (including 6 new cases of our own) to evaluate whether this is still appropriate. Descriptive statistics and distribution of each pathologic type have been updated, based on 515 cases, and have changed from statistics compiled on 155 cases by G. A. Absehouse et al. Only seven per cent of all adrenal cysts are malignant or potentially malignant. There is only one reported case of a malignancy found in a nonfunctioning adrenal cyst that was initially thought to be benign. In this case, no CT or aspiration was performed. There have been 19 cases of adrenal cysts managed with aspiration. All were nonfunctioning and benign. One had a bloody aspirate. Reaccumulation occurred in 32 per cent of the cases (six cases); six per cent were symptomatic, four per cent were excised. Follow up was available in 15 cases from 4 months to 3.5 years. Management of the patient with a suspected adrenal cyst should include a careful history and physical and biochemical screening to rule out a functioning lesion. A CT scan, and aspiration of the cyst with a cystogram should be performed to confirm a simple cyst of the adrenal. If the suspicion of malignancy is low, and the lesion is nonfunctional, the adrenal cyst may be managed by aspiration alone. If the cyst recurs and is asymptomatic, it may be observed. If a symptomatic cyst recurs, it may be reaspirated or excised.
          Article 0 comments Cited 27 times – based on 0 reviews     Review now
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            Giant adrenal cyst: management and review of the literature.

            D Tagge, P. Baron (1997)
            The diagnosis of adrenal cysts is becoming increasingly more common with the widespread use of diagnostic imaging modalities. Most adrenal cysts are asymptomatic and less than 10 cm in diameter when discovered incidentally. Symptoms appear when adrenal cysts enlarge sufficiently to cause pain and gastrointestinal disturbances or become palpable. In this report, we present a case of a giant 45-cm right adrenal cyst manifesting as painless abdominal distention in a 23-year-old female. This case appears to be one of the largest adrenal cysts reported to date. The classification and management of adrenal cystic lesions is reviewed.
            Article 0 comments Cited 13 times – based on 0 reviews     Review now
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              Adrenal cysts: imaging and percutaneous aspiration.

              R Pfister, Kyriakos Papanicolaou, G A Tung … (1989)
              Six patients with primary adrenal cysts were encountered during a period of 3 years. Multiple imaging modalities were used to characterize these lesions, including magnetic resonance imaging in one case. Percutaneous aspiration was performed on four of the six cysts - in one case, in the operating room prior to excision of the cyst. Cholesterol was detected in four cysts and cortisol in one cyst. Cytologic findings from aspiration biopsy were benign in all five cases. Two cysts were removed, one of them after reaccumulation of the fluid after needle aspiration. The findings in this small series of adrenal cysts suggest that in certain cases, complete cyst aspiration, rather than surgical excision, may be carried out initially for diagnosis and management of indeterminate suprarenal cystic lesions and symptomatic cysts of the adrenal gland.
              Article 0 comments Cited 9 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Surg Case Rep
                Journal ID (iso-abbrev): J Surg Case Rep
                Journal ID (hwp): jscr
                Journal ID (publisher-id): jscr
                Title: Journal of Surgical Case Reports
                Publisher: JSCR Publishing Ltd
                ISSN (Electronic): 2042-8812
                Publication date (Electronic): 1 June 2012
                Publication date Collection: June 2012
                Volume: 2012
                Issue: 6
                Page: 16
                Affiliations
                St. Vincent Hospital, Indianapolis, USA
                Article
                DOI: 10.1093/jscr/2012.6.16
                PMC ID: 3862249
                SO-VID: aa6d4186-4d98-4bfc-9a69-de814f92b65f
                Copyright © © JSCR
                History
                Categories
                Subject: Urology
                Subject: 0170

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