title: Diagnosis and treatment of the adrenal cyst.
abstract: Adrenal cysts, first described in 1670, typically presented with abdominal pain or palpable mass. In the modern era, incidentally identified adrenal cysts are commonplace, as imaging studies have become a mainstay in patient evaluation. The rubric of adrenal cysts comprises a broad differential diagnosis, rendering definitive diagnosis and subsequent management difficult. These cysts are categorized into four subtypes: endothelial, pseudocyst, epithelial, and parasitic. Endocrine workup should rule out functional status. Radiologic differentiation is helpful; however, imaging characteristics, such as hemorrhage in a pseudocyst, can confound identification of benign versus malignant lesions. Any functional lesion, potentially malignant lesion, or benign lesion more than 5 cm in diameter deserves surgical treatment. For small, benign lesions, conservative management is a viable option, although no surveillance protocols have been described.
authors.affiliation: Department of Urology, Mount Sinai Medical Center, One Gustave Levy Place, Box 1272, New York, NY, 10029, USA. Alexei.wedmid@mssm.edu
authors.forename: Alexei
authors.initials: A
authors.lastname: Wedmid
authors.forename: Michael
authors.initials: M
authors.lastname: Palese
mesh_terms: D000307:Adrenal Gland Diseases / Q000145:classification / Q000175:diagnosis / Q000601:surgery; D000315:Adrenalectomy / Q000379:methods*; D044963:Biopsy, Fine-Needle; D003560:Cysts / Q000145:classification / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*