70 Left Adrenal Cyst

VI Adrenal Glands

CASE 70

Clinical Presentation

A 52-year-old woman complaining of nonspecific abdominal pain.

Fig. 70.1 (A) Ultrasound image shows the complex left suprarenal lesion containing multiple septations and mixed hypo-and hyperechoic debris. (B) Axial contrast-enhanced CT image in the same patient shows a large well-defined, thick-walled, complex cystic lesion with hyperdense heterogeneous contents.

Radiologic Findings

Axial computed tomography (CT) and ultrasound images of a left adrenal mass show a large well-defined, thick-walled, complex cystic lesion with heterogeneous contents (Fig. 70.1).

Diagnosis

Left adrenal cyst

Differential Diagnosis

Adenoma
Parasitic (hydatid) cyst
Cystic pheochromocytoma
Cystic adrenal carcinoma
Pseudocyst of pancreas, exophytic renal cyst, cystic schwannoma, or cystic adenomatoid tumor mimicking an adrenal cystic lesion

Discussion

Background

Adrenal cystic lesions are more commonly seen in women. It is important to distinguish adrenal cysts from adenoma because adenoma is treated conservatively, whereas adrenal cysts may need surgical intervention if imaging appearances suggest the possibility of complications.