title: A unique presentation of a complex haemorrhagic adrenal pseudocyst.
abstract: A man aged 33 years presented with a 3-day history of left-sided testicular discomfort. Clinical examination revealed a large left-sided varicocele. He was referred for a testicular ultrasound, which demonstrated a moderate left-sided varicocele and an associated large suprarenal mass. An urgent (CT) scan was arranged which confirmed this, with associated compression of adjacent structures, including the left kidney and left renal vessels. The patient was admitted 1 week following the CT scan with features of sepsis. An inpatient adrenal MRI scan suggested the presence of a large left-sided haemorrhagic adrenal cyst. This was removed surgically through a left subcostal incision. Histology confirmed there was no malignancy. The patient was discharged and a follow-up CT scan at 6 months showed complete resolution of the cyst with no further testicular discomfort. This is the first known case of an adrenal cyst presenting with a varicocele.
authors: Darent Valley Hospital, Dartford, UK.
authors: Ryan James
authors: RJ
authors: Geleit
authors: Department of General Surgery, Dartford and Gravesham NHS Trust, Dartford, UK.
authors: Rakesh
authors: R
authors: Bhardwaj
authors: Department of Pathology, Maidstone Hospital, Maidstone, UK.
authors: David
authors: D
authors: Fish
authors: Department of Urology, Darent Valley Hospital, Kent, Ohio, USA.
authors: Seshadri
authors: S
authors: Sriprasad
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D000328:Adult; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging; D006470:Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014646:Varicocele / Q000000981:diagnostic imaging / Q000209:etiology*