Large adrenal cyst masquerading as a pancreatic cystic tumor: a rare diagnosis based on endoscopic ultrasound

Abstract

Adrenal cystic lesions constitute a rare finding and usually are diagnosed incidentally as retroperitoneal cysts during imaging studies. A major issue, especially for the large-sized ones, is their preoperative diagnosis and management, as imaging modalities often fail to detect their exact origin prior to surgery. We report a case of a big adrenal cyst that was mistakenly diagnosed and followed up as pancreatic cystic tail tumor. Our thorough workup, which included endoscopic ultrasound (EUS), managed to delineate an adrenal gland-originated cyst and altered further management of the patient. According to our knowledge, this is the first report in literature in which EUS proved its superiority over other imaging studies in clarifying the origin of an ambiguous big retroperitoneal cyst. We believe that for cases of large retroperitoneal cystic lesions, EUS consists the optimal diagnostic and sampling tool.

Unusual cause of chronic abdominal pain in a 17-year-old female: a case report of an epithelial adrenal cyst

“…In some cases, this can lead to misdiagnosis when imaging fails to determine the origin of retroperitoneal tumors; therefore, are diagnosed during surgery. A similar case was reported in a 47-year-old patient with a large adrenal cyst misdiagnosed and followed up as pancreatic cystic tumor [ 10 ]. Another study reported a case of a giant adrenal cyst diagnosed during surgery [ 8 ].…”

Differential Diagnosis of Pancreatic Cyst Tumors

“…A similar clinical situation was described by Korean authors [66]. Extrapancreatic cysts, such as tumors and duplication cysts of the stomach [67], tumors of the left adrenal gland [68], tumors of the spleen [69,70] can imitate pancreatic cysts. In rare cases, echinococcal cysts of the pancreas are found [71].…”