title: A giant adrenal pseudocyst mimicking an adrenal cancer: case report and review of the literature.
abstract: Adrenal pseudocysts are rare lesions that develop within the adrenal glands, generally from vessel ectasia or from degenerative adenomas or hematomas. They are usually non-functional and asymptomatic. The reported potential malignant transformation of an adrenal cyst is ca. 7% and indicates radical excision of these masses. We report the case of a 69-year-old man with hypertension, chronic obstructive pulmonary disease, and obesity in whom microscopic hematuria was detected during a routine examination performed by his family doctor. To investigate the cause of this microscopic hematuria, the patient underwent computed tomography of the abdomen, which showed a well-defined 12-cm lesion of the left adrenal gland with calcification and necrotic components that was compressing the left kidney, pancreas, and spleen. Suspecting adrenal carcinoma, after preoperative staging, a left subcostal laparotomy was performed, with resection of the left adrenal gland, a splenectomy, and resection of the pancreatic tail. The histology showed an adrenal pseudocyst with a fibrous capsule containing amorphous eosinophilic material with calcification and cholesterol crystals. The patient's postoperative course was uneventful, and he was discharged 12 days after surgery.
authors.affiliation: General Surgery Department, Beata Vergine Hospital, Mendrisio, Switzerland. aydy@libero.it
authors.forename: S
authors.initials: S
authors.lastname: Passoni
authors.forename: L
authors.initials: L
authors.lastname: Regusci
authors.forename: G
authors.initials: G
authors.lastname: Peloni
authors.forename: M
authors.initials: M
authors.lastname: Brenna
authors.forename: F
authors.initials: F
authors.lastname: Fasolini
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000601:surgery*; D000311:Adrenal Glands / Q000473:pathology*; D000368:Aged; D002114:Calcinosis / Q000175:diagnosis; D002784:Cholesterol / Q000378:metabolism; D003560:Cysts / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009765:Obesity / Q000150:complications; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D016896:Treatment Outcome
chemical_list: D002784:Cholesterol