Adrenal Cysts: Natural History by Long-Term Imaging Follow-Up

Ricci, Zina J.; Chernyak, Victoria; Hsu, Kevin; Mazzariol, Fernanda S.; Flusberg, Milana; Oh, Sarah K.; Stein, Marjorie W.; Rozenblit, Alla M.

doi:10.2214/ajr.12.9202

Cited by 43 publications

(22 citation statements)

References 40 publications

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“…There is no predilection for the right versus left gland, and bilateral cysts are present in approximately 15% of cases (34). These cysts can range in size from less than a centimeter to greater than 20 cm (32-34), although most are small to medium-sized, with one recent study reporting median and mean baseline sizes of 4.2 cm and 5.3 cm, respectively (35).…”

Section: Adrenal Cystsmentioning

confidence: 99%

From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation

Lattin¹,

Sturgill²,

Tujo³

et al. 2014

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Advanced imaging often reveals adrenal tumors and tumor-like conditions in both symptomatic and asymptomatic patients. When adrenal disease is clinically suspected, cross-sectional imaging can be helpful in evaluating the etiology of the patient's symptoms. When adrenal disease is incidentally identified, what the clinician and patient really want to know is whether the findings are benign or malignant, as this ultimately will affect their next step in management. Using radiologic-pathologic correlation, we broadly classify common, uncommon, and rare tumors and tumor-like conditions that can occur in the adrenal as benign or malignant. This classification follows predominant trends in observed biologic behavior while acknowledging those tumors that may behave in the minority in an unpredictable manner. We review the clinical background and presentation of functional adrenal tumors including Conn syndrome, Cushing syndrome, and catecholamine-secreting tumors, as well as their relationship with adrenal anatomy. We discuss a variety of benign tumors, including adrenal cortical adenoma (including oncocytoma) and pheochromocytoma, as well as uncommonly and rarely encountered tumors such as myelolipoma, hemangioma, lymphangioma, schwannoma, ganglioneuroma, and adenomatoid tumor. A variety of tumefactive but nonneoplastic lesions are addressed, including adrenal cortical hyperplasia, adrenal hemorrhage, adrenal cysts, and infections. Malignant tumors discussed include adrenal cortical carcinoma, the rare malignant pheochromocytoma, lymphoma, metastases, and sarcomas. For each tumor and tumor-like lesion, the clinical presentation, epidemiology, key imaging findings, diagnostic differential considerations, and management options are briefly addressed. Finally, an approach to the workup of suspected or incidentally discovered tumors is presented based on a selected literature survey and our clinical experience. Radiologists play an important role in identification and diagnosis of adrenal tumors and tumor-like conditions in both symptomatic and asymptomatic patients.

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Section: Adrenal Cystsmentioning

confidence: 99%

From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation

Lattin¹,

Sturgill²,

Tujo³

et al. 2014

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127

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“…Además, del potencial de malignización, se han reportado otras indicaciones quirúrgicas en QA no funcionales, incluyendo: el crecimiento del QA, la hemorragia con colapso cardiovascular, la ruptura quística, o el compromiso de órganos vecinos con incertidumbre etiológica 1,2,[13][14][15] . En este caso se descartó funcionalidad, hubo crecimiento quístico, hallazgos de complejidad e incertidumbre etiológica con sospecha de compromiso renal, que no se aclaró con imágenes (ecografía, TC de abdomen y ecoendoscopia), por lo que se resecó.…”

Section: Discussionunclassified

“…La historia natural del QA ha sido pobremente reportada en la literatura y la información es escasa en términos de manejo definitivo 2 . Es aceptado que para el correcto abordaje del QA, se requiere dife-Figura 1. evolución escanográfica del quiste adrenal (Qa) en un periodo de 34 meses.…”

Section: Introductionunclassified

Manejo quirúrgico del quiste adrenal gigante: Reporte de caso y revisión de la literatura

et al. 2019

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Objective: Present a giant adrenal cyst (AC) case treated with minimally invasive resection and to perform a narrative literature review available. Material and Methods: A 54 year-old male presents with a left retroperitoneal slow growing mass, no symptoms, with a complex AC evidenced by previous images and mass biopsy, with suspected renal infiltration. A transabdominal laparoscopic resection is indicated. Results: A complex hemorrhagic 9 cm diameter AC was found, with adhesions to left Gerota's fascia. Complete resection of the AC was achieved through minimally invasive approach. The patient had an uneventful clinical recovery and was discharged on the second postoperative day. On 19th month of follow-up is completely asymptomatic. Even though the AC are benign lesions, the symptomatic giant AC, with fast growing ratio, and/or hemorrhagic conversion could be resected though laparoscopic adrenalectomy, with no increased morbidity or mortality. Discussion: The laparoscopic approach for giant non-functional AC should be considered as the standard of care. More evidence is required in terms of surgical approach outcomes to define clear recommendations. Conclusion: This report adds to the actual evidence in terms of minimally invasive approach for hemorrhagic giant AC.

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“…In a series of 20 patients, Ricci et al 12 reported that lesion enlargement was actually a frequent finding on follow-up and as an isolated manifestation should not be considered as suspicious for malignancy.…”

Section: Discussionmentioning

confidence: 99%

Postsurgical large adrenal cyst recurrence: treatment by means of percutaneous alcohol ablation

Hatzidakis¹,

Kozana

Petrakis

et al. 2014

BMJ Case Reports

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We describe a case of a 28-year-old man who presented with symptomatic, right-sided, large adrenal cyst recurrence 9 months after laparoscopic decortication. Final treatment was achieved by means of percutaneous aspiration and ethanol ablation. On 6-month follow-up the patient was asymptomatic and the cyst remained minimised. In our opinion, percutaneous treatment with alcohol ablation of primary benign symptomatic or recurrent uncomplicated adrenal cysts should be considered as an effective alternative method when patients are frail or surgery fails to resolve the problem.

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Adrenal Cysts: Natural History by Long-Term Imaging Follow-Up

Abstract: Interval enlargement of an adrenal cyst is frequent and as an isolated finding does not indicate malignancy or presence of a complication. However, some adrenal cysts may decrease or remain stable in size over time.

Cited by 43 publications

References 40 publications

From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation

From the Radiologic Pathology Archives: Adrenal Tumors and Tumor-like Conditions in the Adult: Radiologic-Pathologic Correlation

Manejo quirúrgico del quiste adrenal gigante: Reporte de caso y revisión de la literatura

Postsurgical large adrenal cyst recurrence: treatment by means of percutaneous alcohol ablation

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