A prenatally detected adrenal cyst treated by adrenal-sparing surgery

Erikçi, Volkan Sarper; Uçan, Başak; Arslan, Osman; Öztürk, Canan; Aksoy, Nail; Dursun, Ahmet; Hoşgör, Münevver

doi:10.1097/01.xps.0000405609.56525.d1

Cited by 5 publications

(6 citation statements)

References 14 publications

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“… 8 Another case report documented an adrenal pseudocyst in pregnancy which had to be excised at laparotomy while the pregnancy was carried to term delivery. 9 10 Treatment is done by surgical excision, which can be done laparoscopically depending on the size of the lesion. 2 There was no case report of a haemorrhagic suprarenal cysts presenting with predominantly respiratory symptoms of cough and shortness of breath in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…There was a case report of a haemorrhagic suprarenal pseudocyst presenting as a varicocele 8. Another case report documented an adrenal pseudocyst in pregnancy which had to be excised at laparotomy while the pregnancy was carried to term delivery 9 10. Treatment is done by surgical excision, which can be done laparoscopically depending on the size of the lesion 2.…”

Section: Discussionmentioning

confidence: 99%

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A huge haemorrhagic suprarenal pseudocyst: an unusual presentation of a rare condition

Olowu

Alzehairy

2021

BMJ Case Rep

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Haemorrhagic suprarenal pseudocysts are very rare and are often incidental findings at surgery or autopsy, though they can sometimes present with predominantly gastrointestinal or endocrine symptoms, including intraperitoneal bleeding or sepsis. Our case report is of a 48-year-old man who presented at our primary healthcare centre with 2-month history of predominantly respiratory symptoms of cough and shortness of breath. CT scan revealed a suprarenal cyst measuring 14.2×13.5×13.1 cm for which he was operated and made a full recovery. A detailed literature review reveals that there has never been a case of a haemorrhagic suprarenal pseudocyst presenting with predominantly respiratory symptoms, which is why we decided to document this case report.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A huge haemorrhagic suprarenal pseudocyst: an unusual presentation of a rare condition

Olowu

Alzehairy

2021

BMJ Case Rep

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“…The etiologies of FAH in the literature are broad and include thrombocytopenia, congenital syphilis, and renal vein thrombosis. 36 A few unique etiologies for FAH have been reported in our systematic review, most of which appear to be due to venous congestion forming in the adrenal gland leading to FAH. These include vein of Galen aneurysmal malformation, 8 BWS, 27 fetal distress and hypoxia, 18 renal vein thrombosis, 25 and agenesis of the IVC with preservation of the hepatic segment and subsequent thrombosis of the left renal vein.…”

Section: Discussionmentioning

confidence: 83%

“…FAH has been described in the literature since the early 1990s as having variable ultrasound features ranging from cystic, mixed (solid and cystic, Figure 2), to solid, 14 which is often indistinguishable from a congenital cystic neuroblastoma 36 . Multiple studies have recommended imaging findings to help distinguish FAH from neuroblastoma.…”

Section: Discussionmentioning

confidence: 99%

Imaging and outcomes of fetal adrenal hemorrhage: A systematic review

Pham,

Biswas,

Levy

et al. 2023

Prenatal Diagnosis

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ObjectiveTo describe prenatal and postnatal imaging findings of fetal adrenal hemorrhage (FAH) and its associated perinatal outcomes, including frequency of postnatal surgical intervention.MethodA systematic literature review of seven electronic databases was conducted from inception until January 2022, with 2008 articles identified reporting prenatally identified fetal adrenal masses. Studies with confirmed FAH diagnosis were included. Quality and risk assessment were evaluated.ResultsThirty‐five studies, including 102 FAH cases, were analyzed. FAH was commonly described as cystic (28/90, 31%), anechoic (25/90, 28%), or mixed echogenic (14/90, 16%) on ultrasound. Outcome data were available for 65 cases (64%) of FAH: 9% (6/65) resolved prenatally, 35% (23/65) resolved postnatally, 34% (22/65) regressed in size after birth, and 22% (14/65) persisted postnatally. Overall, 25% (16/65) of cases underwent postnatal surgical intervention. Neuroblastoma was suspected in all 16 surgical cases. Only one case (1/16, 6%) confirmed a cystic hematoma with microscopic islets of neuroblastoma in situ on pathology.ConclusionPrenatal diagnosis of FAH is challenging due to the significant heterogeneity of ultrasound findings. Final pathology did not support the need for surgical intervention. Persistent postnatal FAH warrants shared decision making for further management based on the clinical presentation.

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“…Management of adrenal or suprarenal cysts is largely by surgical excision to exclude malignancy, as enumerated in an American study, where they reviewed 613 cases, including those they had managed, where they found that only 7% of their cases were malignant or potentially malignant, with only 1 reported malignancy, and concluded that aspiration of the cysts may be done 6 in mind when assessing these patients are benign and malignant lesions like adrenal or suprarenal masses e.g., adenocarcinomas or pheochromocytomas 9 . Other rare lesions identified in case reviews include adrenal angiolipoma as possible differential diagnosis 17 , as well as a mucinous cystic neoplasm 11 , and an unusual prenatal diagnosis of an adrenal cyst in pregnancy which had to be excised at laparotomy while the pregnancy was carried to term delivery 12,13,16 . Possibility of the diagnosis of congenital adrenal teratomas should also be borne in mind when examining neonates 14 , as well as a congenital adrenal cystic neuroblastoma 16 .…”

Section: Literature Reviewmentioning

confidence: 99%

Haemorrhagic suprarenal pseudocysts: a systematic review of a rare condition from family physicians’ perspective during the COVID-19 global pandemic

Olowu¹,

Alzehairy²

2021

J Endocrinol Sci

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Adrenal cysts are rare lesions that could be epithelial, endothelial, parasitic or haemorrhagic[1], as well as pseudocysts. Haemorrhagic adrenal cysts are extremely rare and are often asymptomatic, so diagnosis can be really challenging. This can prove really difficult for primary care physicians who are often the frontline clinicians these patients tend to present to. They are usually benign lesions and do not often cause mortality if detected early and prompt surgery is done, as was the case with the patient in our case report[4]. When they do become symptomatic, they can present with different systemic symptoms as documented in literature, including in our case report[2,4]. Diagnosis is usually through Ultrasound and CT Scan and management is largely laparoscopic or open excision depending on the size of the lesion, surgical expertise and local protocol. Most patients make full recovery and mortality is extremely low [3]. The aim of this review is to provide a broader overview of the subject, highlight salient points in several studies relating to haemorrhagic cysts, provide an up to date follow up information on the index patient in our case report and to explore possible areas for future study [4,6]. This review also includes a suggested management algorithm and intends to emphasize the fact that patients who present in primary, urgent or emergency care settings with persistent non-specific symptoms should be investigated for rare diseases.

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A prenatally detected adrenal cyst treated by adrenal-sparing surgery

Cited by 5 publications

References 14 publications

A huge haemorrhagic suprarenal pseudocyst: an unusual presentation of a rare condition

A huge haemorrhagic suprarenal pseudocyst: an unusual presentation of a rare condition

Imaging and outcomes of fetal adrenal hemorrhage: A systematic review

Haemorrhagic suprarenal pseudocysts: a systematic review of a rare condition from family physicians’ perspective during the COVID-19 global pandemic

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