Imaging spectrum of adrenal pseudocysts on CT

Wang, Li-Jen; Wong, Yon-Cheong; Chen, Chi-Jen; Chu, Shih-Ming

doi:10.1007/s00330-002-1537-5

Cited by 39 publications

(26 citation statements)

References 16 publications

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“…1 Endothelial cysts are the most commonly occurring followed by pseudocysts. 4 Adrenal pseudocysts are benign, nonfunctional masses arising from the cortex or medulla of the adrenal gland. Symptoms are caused by mass effect, infection, rupture or haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…Classically, adrenal pseudocysts are described as cystic lesions (of homogenous water density) with a fibrous wall and thin internal septations. 1,4 Mural/septal calcification is commonly demonstrated due to haemorrhage, 1 this is discernible from central/amorphous calcification seen in malignant disease. As in this case, pseudocysts can contain solid components or layering secondary to haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…The key to differentiating organised haematoma from tumour is the lack of enhancement. 4 If serial imaging is undertaken in these patients rapid changes in the solid components may be seen reflecting resolving haematoma. 7 In conclusion, adrenal pseudocysts are rare and have a wide differential.…”

Section: Discussionmentioning

confidence: 99%

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Giant adrenal pseudocyst: A rare diagnosis

Haines¹,

Macallister²

2018

J Med Imag Rad Onc

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We present a rare case of giant adrenal pseudocyst as a cause of right upper quadrant (RUQ) pain and highlight the typical multimodality imaging features. The case demonstrates the imaging features associated with giant adrenal pseudocysts to aid accurate and timely diagnosis. Despite the rarity of these lesions they are important to consider as benign lesions can closely mimic malignant ones. Unenhanced and contrast-enhanced CT is the imaging of choice for adrenal cysts. However, MRI can provide more exquisite assessment of cystic, solid and enhancing components. Pseudocysts can be purely cystic, mixed or solid. Classically, adrenal pseudocysts are described as cystic lesions (of homogenous water density) with a fibrous wall and thin internal septations. Mural/septal calcification is commonly demonstrated due to haemorrhage, this is discernible from central/amorphous calcification seen in malignant disease. As in this case, pseudocysts can contain solid components or layering secondary to haemorrhage. The key to differentiating organised haematoma from tumour is the lack of enhancement. If serial imaging is undertaken in these patients rapid changes in the solid components may be seen reflecting resolving haematoma. Adrenal pseudocysts are rare and have a wide differential. Cystic adrenal lesions warrant multimodality assessment as their imaging features aid diagnosis and differentiation from malignant disease. We suggest that MRI plays a complimentary role to CT. CT is superior at demonstrating mural/septal calcification but MRI aids in determining cystic components and differentiating haemorrhage from tumour.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Giant adrenal pseudocyst: A rare diagnosis

Haines¹,

Macallister²

2018

J Med Imag Rad Onc

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“…Adrenal cysts are often discovered incidentally, and the reported incidence is increasing due to increased detection rates from more liberal use of imaging in the present era [1]. The incidence is reported as 0.064% in surgical series and 0.18% on autopsies [2].…”

Section: Discussionmentioning

confidence: 99%

All Those Liver Masses are not Necessarily from the Liver: A Case of a Giant Adrenal Pseudocyst Mimicking a Hepatic Cyst

et al. 2015

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Patient: Male, 50Final Diagnosis: Adrenal pseudocysSymptoms: Abdominal pain • feverMedication: —Clinical Procedure: —Specialty: —Objective:Unusual clinical courseBackground:Most abdominal cysts, including adrenal pseudocysts, are benign and asymptomatic. Rapid enlargement, hemorrhage, infection, rupture with leakage of cyst contents, or pressure on adjacent organs can cause symptoms. Although usually diagnosed incidentally on imaging, determining the origin of a cyst can sometimes be challenging. In these situations, surgical excision and pathological analysis is crucial to diagnosis and management. We report here a case of a giant symptomatic adrenal pseudocyst that closely mimicked a hepatic cyst at presentation.Case Report:A 50-year-old man, with a history of an incidentally detected hepatic cyst, presented with severe abdominal pain, fevers, leukocytosis, and mildly abnormal liver function tests. CT scan revealed a large well defined cystic space-occupying lesion within the liver, with findings suggesting cyst rupture and possible infection. Early laparotomy was performed, and the origin was determined intraoperatively to be right adrenal, which was later confirmed by pathology.Conclusions:Contrast-enhanced CT scan is the criterion standard for evaluation for abdominal cystic masses. Precise diagnosis of a giant abdominal cyst can be challenging. Surgery is both diagnostic and curative in such situations. We also discuss the specific situations in which surgery should be considered in cases of adrenal cystic masses.

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“…Calcifications may be seen in adrenal cysts, as in our case. In addition, the lack of enhancement of solid elements of a mass may help in the differential diagnosis of pseudocyst versus adrenal neoplasm [12]. Other modalities that have been used to evaluate cysts include ultrasonography and magnetic resonance imaging (MRI).…”

Section: Discussionmentioning

confidence: 99%

Giant Adrenal Pseudocyst Treated Laparoscopically; Case Report and Review of the Literature

Aloraifi¹,

O’Brien²,

Broe³

2008

TOSJ

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We report a case of a giant adrenal pseudocyst, found incidentally in a 45 year old female. Her CT scan showed a 7.5cm x 7.3cm suprarenal mass and she underwent a laparoscopic transperitoneal adrenalectomy. We report this case and review the literature regarding the diagnosis and management of adrenal pseudocysts. CASE REPORTA 45 year old housewife with multiple sclerosis was discovered to have a large right suprarenal mass as an incidental finding on a computed tomography (CT) scan of her lumbosacral spine. On close questioning, she reported a vague history of episodes of right flank pain for the previous 2 years. She also described episodes of flushing and lethargy which raised a suspicion of a possible diagnosis of phaeochromocytoma. There was no prior history of trauma or malignancy. The examination was normal other than a palpable mass in the right upper quadrant.An adrenal protocol CT scan was performed revealing a 7.5cm x 7.3cm suprarenal cystic lesion with a calcified rim (Figs. 1,2). A renal or adrenal origin of the mass was difficult to distinguish. Otherwise, no metastatic disease was seen. The possibility of a phaeochromocytoma was considered, although these tumors normally display enhancement. Figs. (1,2). CT abdomen with contrast showing 7.5cm x 7.3cm mass in the supra-renal area. The calcified rim is well depicted here.

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Imaging spectrum of adrenal pseudocysts on CT

Cited by 39 publications

References 16 publications

Giant adrenal pseudocyst: A rare diagnosis

Giant adrenal pseudocyst: A rare diagnosis

All Those Liver Masses are not Necessarily from the Liver: A Case of a Giant Adrenal Pseudocyst Mimicking a Hepatic Cyst

Giant Adrenal Pseudocyst Treated Laparoscopically; Case Report and Review of the Literature

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