A Case of spontaneous hemorrhagic pseudocyst of adrenal gland mimicking cystic pheochromocytoma / 대한내과학회지

Cysts of the adrenal glands are uncommon and present difficult problems in differential diagnosis. In autopsy studies, the incidence of adrenal cysts is ranges from 0.064% to 0.18%. Recently, we have experienced a 22-year-old female patient with spontaneous hemorrhagic pseudocyst of adrenal gland without known cause, presenting symptoms of nausea, epigastric discomfort and intermittent pain of right upper abdomen. In clinical presentation, abdominal ultrasonogram and computerized tomogram suggest cystic degeneration of malignant pheochromocytoma, but screening hormonal evaluation was normal. Selective adrenal venous sampling, adrenal scintigram and pathologic examination were not compatible with the functioning adrenal cortical or medullary adenoma/carcinoma, the mass results in spantaneous hemorrhagic necrosis and cystic degeneratio#n of adrenal gland. The authors reported a case of spontaneous hemorrhagic pseudocyst of adrenal gland, which was successfully resected by laparoscopic excision with reviews of the literatures.

A Case of Traumatic Nonfuctional Adrenal Pseudocyst / 대한내분비학회지

The adrenal glands are rarely injured by blunt trauma, because they are well protected by the ribs, paraspinal muscles, and the overlying abdominal contents. Although most of adrenal cysts are clinically silent, the number of incidentally detected adrenal cysts have increased due to advanced and widespread application of various sensitive imaging methods. Recently, we have encountered a case of a 62-year-old man who have developed a left adrenal pseudoeyst one and a half months after the blunt trauma from a pedestrian traffic accident. The pseudocyst was non-functional and measured about 5 * 4 cm in size with the same fluid density of a gall bladder in abdominal computerized tomography(CT). Turbid cystic fluid was aspirated by CT-guided method, and the aspirate was composed of degenerated old blood cells without any malignant cells. Since the cyst was developed following trauma and its microscopic content showed blood cells, impending rupture was anticipated. Hence, a laparoscopic adrenalectomy was performed.

Adrenal Pseudocyst as a Result of Longterm Intake of Steroid Hormone

Adrenal pseudocysts are uncommon lesions which usually occur as a result of hemorrhage within the adrenal tissue. Adrenal hemorrhage is usually associated with severe stress, sepsis, pregnancy, syphilis, leukemia, or anticoagulant therapy but during steroid therapy, it is very rare. We report a case of adrenal pseudocyst that resulted from hemorrhage into the adrenal gland and is probably related to the exogenous administration of steroids. The patient was a 57-year-old woman who was treated with oradexon for 20 years for the treatment of a maculopapular lesion on her thigh as well as for arthritis. She underwent a right adrenalectomy due to the adrenal cystic mass. The wall of the cystic mass was composed of a thick layer of hyalinized fibrous tissue with remnants of adrenal cortical tissue on the outer aspect. The inner surface had no lining cells and the wall of the cyst contained many calcified plaques with hemosiderin pigment.

A case of infected adrenal pseudocyst / 대한비뇨기과학회지

Cystic lesions of the adrenal are extremely rare. Pseudocysts (39% of all adrenal cysts) are the most common clinically detected cysts and result from hemorrhage into normal adrenal gland due to severe infection and trauma or adrenal neoplasm. Histologically, the lining of adrenal pseudocyst is not covered with epithelium and is composed of connective tissue. We are presenting a case of infected adrenal pseudocyst suffering from right lower chest and upper abdominal pain in a 35-year-old woman with brief review of the literatures.