A unique presentation of a complex haemorrhagic adrenal pseudocyst

Geleit, Ryan; Bhardwaj, R.; Fish, David E.; Sriprasad, Seshadri

doi:10.1136/bcr-2016-216246

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…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.…”

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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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%

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

Olowu

Alzehairy

2021

BMJ Case Rep

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“…In a systematic review, 80% of bleeding adrenal tumours were benign (26). Common benign tumours underlying bleeding include phaeochromocytoma (15), cortical lesions, adrenal pseudo cysts and lipomas (21,30). Malignant adrenal tumours associated with adrenal haemorrhage include adrenocortical carcinoma and metastasis (26).…”

Section: Discussionmentioning

confidence: 99%

“…In the published case reports, most patients are initially treated conservatively (5,(10)(11)(12)(13)(14). Surgical resection has been performed electively by either the open or laparoscopic approach (9,21). CT scan may be performed during follow-up to monitor the size of the haematoma and evaluate any underlying lesion (22).…”

Section: Original Articlementioning

confidence: 99%

Acute non-traumatic adrenal haemorrhage—management, pathology and clinical outcomes

Ali¹,

Singh²,

Balasubramanian³

2018

Gland Surg

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Background: Acute adrenal haemorrhage is a rare medical emergency. The aim of the series was to study the clinical presentation and management of patients presenting with acute non-traumatic adrenal haemorrhage. Methods: The records of patients presenting with an acute abdomen secondary to adrenal haemorrhage and treated in a tertiary endocrine surgical unit over a period of 6 years were reviewed. Results: Of the 11 included patients, there were 4 males and 7 females; the median [range] age at presentation was 58 [27-89] years. All were initially managed conservatively for bleeding, except one who underwent angioembolisation to ensure hemodynamic stability. Two patients underwent percutaneous drainage of persistent collection and suspected sepsis. Biochemical workup showed hyper function with metanephrine excess in 1 patient. Adrenalectomy was performed in 5 patients after a median [range] of 10 [7-11] weeks. Histology showed benign pathology in 2 patients, malignant in 2 patients and necrotic tumour in 1 patient. Two patients died of disseminated metastatic disease at 5 and 2 months after presentation with bleeding. Conservative management in the other 3 patients was successful at a median follow up of 26 [6-66] months. Conclusions: Acute adrenal haemorrhage is usually associated with an underlying pathology; which may be benign or malignant; functional or non-functional. Initial conservative management is preferred as it allows determination of functional status and elective surgery, if necessary.

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“…However, they can cause symptoms through repeated episodes of trauma, infection or bleeding 2 . When they do, they are often non-specific symptoms, for example respiratory symptoms as highlighted in our case study 4 , left testicular discomfort as identified by a case report in the United Kingdom 8 and epigastric pain and abdominal distension 15 . An Indian case report even reported unusual presentations of hypertensive retinopathy, virilization and bleeding diathesis 17 .…”

Section: Introductionmentioning

confidence: 78%

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 unique presentation of a complex haemorrhagic adrenal pseudocyst

Cited by 5 publications

References 17 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

Acute non-traumatic adrenal haemorrhage—management, pathology and clinical outcomes

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

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