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Bapir R, Qader D, Gharib D, Tahir S, Abdullah A, Asaad H, Ahmed S, Ali H, Abdullah H, Ahmed S, Hussein Kakamad F, Aghaways I. Delayed Presenting Gastric Duplication Cyst Mimicking a Left Adrenal Cyst in a Young Female: A Case Report with a Literature Review. Case Rep Gastroenterol 2024; 18:153-160. [PMID: 38524872 PMCID: PMC10959546 DOI: 10.1159/000537972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 01/31/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Gastric duplication cyst (GDC) is a rare congenital anomaly of the gastrointestinal tract. Though GDC is often misdiagnosed, misidentification as an adrenal cyst has rarely been reported. Herein, we report a case of GDC in a young female mimicking an adrenal cyst. Case Presentation A 17-year-old female presented with chronic epigastric pain, nausea, and intermittent vomiting. Physical examinations revealed mild tenderness in the epigastric region. Esophagogastroduodenoscopy showed no abnormality. Ultrasound, contrast-enhanced computed tomography scan, and MRI of the abdomen and pelvis showed an oval-shaped left adrenal cystic lesion measuring 33 × 26 mm. Preoperative blood investigations and hormonal assessments were normal. Laparoscopy showed that the cyst originated from the greater curvature of the stomach. The left adrenal gland was normal. After an intraoperative consultation with a gastrointestinal surgeon, a wedge resection of the cyst was performed. Histopathology confirmed the gastric duplication cyst. Conclusion GDCs are rare congenital malformations that may become symptomatic during adulthood. They can mimic adrenal cysts and lead to misdiagnosis.
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Affiliation(s)
- Rawa Bapir
- Smart Health Tower, Sulaimani, Iraq
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Iraq
| | - Deedar Qader
- Department of Urology, Sulaimani Surgical Teaching Hospital, Sulaimani, Iraq
| | - Dana Gharib
- Smart Health Tower, Sulaimani, Iraq
- Gastroenterology and Hepatology, Teaching Hospital, Sulaimani, Iraq
| | - Soran Tahir
- Smart Health Tower, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
| | - Ari Abdullah
- Smart Health Tower, Sulaimani, Iraq
- Sulaimani Teaching Hospital, Sulaimani, Iraq
| | - Hoshmand Asaad
- Smart Health Tower, Sulaimani, Iraq
- Gastroenterology and Hepatology, Teaching Hospital, Sulaimani, Iraq
| | | | - Hemn Ali
- Smart Health Tower, Sulaimani, Iraq
| | - Hiwa Abdullah
- Smart Health Tower, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
| | - Sasan Ahmed
- Smart Health Tower, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
| | - Fahmi Hussein Kakamad
- Smart Health Tower, Sulaimani, Iraq
- College of Medicine, University of Sulaimani, Sulaimani, Iraq
- Kscien Organization, Azadi Mall, Sulaimani, Iraq
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Khan T, Sabu B, Ranganayaki V, Rafeekha P, Thomas R. Management of giant adrenal pseudocyst in pregnancy - A unique approach and review of literature. Obstet Med 2023; 16:52-55. [PMID: 37139502 PMCID: PMC10150310 DOI: 10.1177/1753495x221089210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022] Open
Abstract
Pseudocysts of the adrenal gland are rare and in the majority of cases are non- functioning. They become symptomatic only when they are complicated by hormonal excess, rupture, haemorrhage or infection. Described here is a 26-year-old woman who developed an acute abdomen at 28 weeks of gestation due to a left adrenal haemorrhagic pseudocyst. A conservative approach was adopted, which was followed by elective term caesarean delivery with surgical intervention at the same time. The described case is unique in terms of strategizing timing and mode of management and thus minimizing the risk of prematurity and maternal morbidity associated with interval surgery.
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Affiliation(s)
- Tazeen Khan
- Department of High-Risk pregnancy and
Perinatology, KIMS Health, Trivandrum, Kerala, India
| | - Brinda Sabu
- Department of High-Risk pregnancy and
Perinatology, KIMS Health, Trivandrum, Kerala, India
| | | | - P Rafeekha
- Department of Obstetrics and Gynaecology, KIMS Health, Trivandrum, Kerala, India
| | - Renu Thomas
- Department of Urology, KIMS Health, Trivandrum, Kerala, India
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3
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Gubbiotti MA, LiVolsi V, Montone K, Baloch Z. A Cyst-ematic Analysis of the Adrenal Gland: A Compilation of Primary Cystic Lesions From Our Institution and Review of the Literature. Am J Clin Pathol 2022; 157:531-539. [PMID: 34596217 DOI: 10.1093/ajcp/aqab156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/12/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Although primary adrenal lesions and metastases are most commonly encountered, de novo cysts of the adrenal gland can occasionally occur. METHODS We analyzed the pathology archives at the Hospital of the University of Pennsylvania for diagnoses of cystic lesions of the adrenal gland between 1998 and 2020. Patient demographics and clinical information were extracted, and pathology slides and stains, as appropriate, were analyzed. The literature between 1998 and 2020 was also searched for large case series involving cystic adrenal lesions. RESULTS We found 18 cystic lesions of the adrenal gland in our archives, categorized as pseudocysts (7), endothelial cysts (5), mesothelial cysts (2), mature teratoma (1), cystic adrenal cortical adenoma (1), cystic pheochromocytoma (1), and cystic metastasis (1). The mean age at time of diagnosis was 52.3 years, and the mean size of the cysts was 6.0 cm. There was a slight female predilection, and cysts were more likely to be found on the left side. All lesions were incidental findings. The cystic metastasis was clear cell renal cell carcinoma. Our findings were also compared with those found in the literature published within the same timeframe. CONCLUSIONS Adrenal cysts are rare entities. Our findings are concordant with other large studies and provide additional cases to the existing literature. In addition, our literature search expands the possible differential diagnoses for cystic lesions arising in the adrenal gland.
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Affiliation(s)
| | - Virginia LiVolsi
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Kathleen Montone
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Zubair Baloch
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Issam R, Amine MM, Meriam T, Ahmed C, Mehdi B, Mourad HS. Lymphangiomatous endothelial cyst of the adrenal gland: A case report. Urol Case Rep 2021; 39:101859. [PMID: 34621624 PMCID: PMC8479637 DOI: 10.1016/j.eucr.2021.101859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 11/17/2022] Open
Abstract
Cystic adrenal tumors are rare with an incidence of approximately 0.06% in the general population. Four main histological types are distinguished: Endothelial cysts of lymphangiomatous or angiomatous origin, pseudocysts, epithelial cysts and cysts of parasitic origin. Surgery is recommended for signs of complications, suspicion of malignancy and large size. In other cases, simple surveillance can be proposed. We report here a case of a lymphangiomatous endothelial cyst of the adrenal gland. The objective is to recall the clinical characteristics and to specify the diagnostic contribution of imaging as well as the therapeutic modalities of this entity.
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Affiliation(s)
- Rekik Issam
- Habib Bourguiba Hospital, Urology Department, Sfax, Tunisia
| | | | - Triki Meriam
- Habib Bourguiba Hospital, Urology Department, Sfax, Tunisia
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5
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Ramírez-Beltrán AA, Rosas-Nava JE, Franco-Morales A, Medrano-Urtecho HM, González-Cuenca E, Corona-Montes VE, Maldonado-Ávila M, Jaspersen-Gastelum J. Adrenal cyst: our experience in its laparoscopic management. CIR CIR 2021; 89:252-257. [PMID: 33784286 DOI: 10.24875/ciru.20000265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
ANTECEDENTES Los quistes suprarrenales son una afección rara. Su diagnóstico y su tratamiento son un desafío debido a la escasa información, lo que genera incertidumbre respecto al mejor manejo. CASOS CLÍNICOS Presentamos tres casos de quistes suprarrenales que recibieron tratamiento de mínima invasión con cirugía laparoscópica, sin presentar complicaciones y con una evolución favorable. DISCUSIÓN Las nuevas técnicas quirúrgicas de mínima invasión ofrecen una oportunidad terapéutica que permite preservar estructuras y obtener material necesario para su diagnóstico histopatológico, así como la resolución de la sintomatología. BACKGROUND Adrenal cysts are a rare entity; their diagnosis and treatment are challenging due to the lack of information, generating uncertainty regarding the best management. CASE REPORTS We present three cases of adrenal cysts that received minimally invasive treatment with laparoscopic surgery, without complications and with a favorable evolution. DISCUSSION The new minimally invasive surgical techniques offer a therapeutic opportunity that allows preserving structures and obtaining the necessary material for histopathological diagnosis, as well as a resolution of the symptoms.
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Affiliation(s)
| | - Jesús E Rosas-Nava
- Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - Alfonso Franco-Morales
- Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | | | - Eduardo González-Cuenca
- Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - Víctor E Corona-Montes
- Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
| | - Miguel Maldonado-Ávila
- Servicio de Urología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
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Yokoyama Y, Tajima Y, Matsuda I, Kamada K, Ikehara T, Uekusa T, Momose H, Yoneyama S, Sakata H, Hidemura A, Suzuki H, Ishimaru M. Differential diagnosis and laparoscopic resection of an adrenal pseudocyst: A case report. Int J Surg Case Rep 2020; 72:178-82. [PMID: 32544825 DOI: 10.1016/j.ijscr.2020.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/26/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Adrenal pseudocysts are infrequent entities and definite preoperative diagnosis is difficult. We present a case of left adrenal pseudocyst, which was intraoperatively identified as having an adrenal origin and was resected using a laparoscopic approach. PRESENTATION OF CASE A 41-year-old female was referred to our hospital for examination and treatment of a cystic lesion in the pancreatic tail. Preoperative diagnostic imaging studies showed a cystic lesion with intramural nodular structure, measuring 39 mm in the largest diameter and located between the pancreatic tail and the left adrenal gland. However, the origin of the cystic lesion remained unclear, and a definite preoperative diagnosis was not established. The cystic lesion was intraoperatively identified as having an adrenal origin after the division of the loose connective tissue layer around the lesion under the laparoscopic magnified view. Laparoscopic left adrenalectomy was performed as radical treatment and the histopathological diagnosis confirmed the presence of an adrenal pseudocyst. DISCUSSION We could not ascertain the origin of the cystic lesion from the left adrenal gland and establish a definite diagnosis based on the findings of the preoperative diagnostic imaging modalities. Laparoscopic surgery could be more advantageous than the conventional open approach as not only a minimally invasive treatment option but also as an intraoperative diagnostic tool for cystic lesions in the pancreatic tail. CONCLUSION This case report suggests that laparoscopic surgery could be clinically useful as not only a minimally invasive treatment but also an intraoperative diagnostic tool for cystic lesions in the pancreatic tail region.
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7
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Kim HC, Kang Y, Maeng YH, Kim J, Yoon SP. Incidentally found cystic lymphangioma of the adrenal gland in an elderly male cadaver. Yeungnam Univ J Med 2019; 36:265-268. [PMID: 31620643 PMCID: PMC6784650 DOI: 10.12701/yujm.2019.00262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/07/2019] [Accepted: 07/11/2019] [Indexed: 12/03/2022] Open
Abstract
Adrenal cystic lymphangiomas are extremely rare entities that are often identified incidentally, with less than 60 cases reported to date. We found a protruding ovoid mass consisting of a multiloculated cystic lesion within right adrenal gland in the cadaver of a 75-year-old Korean man. The epithelial cells lining the adrenal cyst were diffusely positive for cluster of differentiation 31 and podoplanin, and negative for pan-cytokeratin. The histopathological diagnosis confirmed a cystic lymphangioma arising from the adrenal gland. Post-mortem findings of the present case are discussed based on the clinicopathological features of adrenal cystic lymphangiomas.
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Affiliation(s)
- Hee Cheol Kim
- Medical Course, Jeju National University School of Medicine, Jeju, Korea
| | - Yunji Kang
- Medical Course, Jeju National University School of Medicine, Jeju, Korea
| | - Young Hee Maeng
- Department of Pathology, Jeju National University School of Medicine, Jeju, Korea
| | - Jinu Kim
- Department of Anatomy, Jeju National University School of Medicine, Jeju, Korea
| | - Sang-Pil Yoon
- Department of Anatomy, Jeju National University School of Medicine, Jeju, Korea.,Institute for Medical Science, Jeju National University, Jeju, Korea
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8
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Olaoye IO, Adesina MD, Afolayan EA. A giant adrenal cyst with an uncertain preoperative diagnosis causing a dilemma in management. Clin Case Rep 2018; 6:1074-1076. [PMID: 29881567 PMCID: PMC5986023 DOI: 10.1002/ccr3.1519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 02/10/2018] [Accepted: 03/08/2018] [Indexed: 11/06/2022] Open
Abstract
Giant Adrenal cysts are rare differentials of retroperitoneal cysts that often present dilemma in diagnosis. A man presented with a huge retroperitoneal cyst and an uncertain preoperative diagnosis. Initial working diagnosis of urinoma and an attempt at drainage had to be abandoned for complete excision before obtaining a histological diagnosis.
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9
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Wale DJ, Wong KK, Viglianti BL, Rubello D, Gross MD. Contemporary imaging of incidentally discovered adrenal masses. Biomed Pharmacother 2017; 87:256-262. [PMID: 28063406 DOI: 10.1016/j.biopha.2016.12.090] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/08/2016] [Accepted: 12/22/2016] [Indexed: 12/11/2022] Open
Abstract
Adrenal lesions are routinely encountered incidentally in clinical practice. Although most of these lesions are benign, malignancy needs to be excluded. Therefore, the initial clinical workup is to exclude aggressive characteristics suggesting malignancy and to identify characteristics predictive of the most common benign lesion, an adrenal adenoma. Predicting a benign adenoma using a variety of imaging modalities has been widely studied using unenhanced computed tomography (CT), contrast enhanced CT, and magnetic resonance (MR) imaging. This review article describes the currently used imaging protocols and clinical interpretation criteria of common adrenal lesions. An adenoma can be predicted if a homogenous soft tissue adrenal mass demonstrates low attenuation (upper threshold value of 10 Hounsfield Units) on unenhanced CT, demonstrates an absolute enhancement washout of ≥ 60% and/or relative enhancement washout of ≥ 40% on adrenal washout contrast enhanced CT, or demonstrates signal loss in opposed-phased MR imaging. If an adrenal adenoma cannot be predicted based upon these criteria, the lesion should be evaluated for other imaging characteristics that suggest a specific pathology, such as an adrenal cyst or myelolipoma. Although nonspecific and with limitations, 18F-fluorodeoxyglucose (FDG) PET/CT has a potential role for differentiating benign from malignant lesions based upon the amount of radiopharmaceutical uptake with malignant lesions generally having greater uptake. If clinical and/or hormonal screening suggests a pheochromocytoma, consideration can be given to 18F-dihydroxyphenylalanine (DOPA) or 123I-metaiodobenzylguanidine (MIBG) in addition to CT and MR. Finally, this review proposes a diagnostic work-up strategy for routine use in clinical practice.
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Affiliation(s)
- Daniel J Wale
- Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA; Department of Nuclear Medicine, Department of Veterans Affairs Health System, Ann Arbor, MI 48105, USA.
| | - Ka Kit Wong
- Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA
| | - Benjamin L Viglianti
- Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA; Department of Nuclear Medicine, Department of Veterans Affairs Health System, Ann Arbor, MI 48105, USA
| | - Domenico Rubello
- Radiology, Medical Physics, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy
| | - Milton D Gross
- Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109, USA; Department of Nuclear Medicine, Department of Veterans Affairs Health System, Ann Arbor, MI 48105, USA
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10
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Michalopoulos N, Laskou S, Karayannopoulou G, Pavlidis L, Kanellos I. Adrenal Gland Lymphangiomas. Indian J Surg 2015; 77:1334-42. [PMID: 27011561 DOI: 10.1007/s12262-015-1206-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/05/2015] [Indexed: 11/25/2022] Open
Abstract
Lymphangiomas of the adrenal glands (ALs) are benign vascular lesions. Approximately, 53 cases have been reported in the literature. The current study reviews and analyzes the clinical and pathologic features of all reported ALs and additionally illustrates a typical case of adrenal lymphangioma (AL). In order to perform the review analysis, a search of the international literature for ALs in adults was conducted. Thirty-eight related articles were found. Clinical and pathological information were obtained for all the reported cases and a database was created. ALs were detected more frequently in women than men. The mean age of occurrence was 39.5 years, while their mean size was 8.86 cm. Fifty-nine percent of ALs were right-sided. Size and localization were responsible for the presenting symptoms, though 30.4 % were asymptomatic. Diagnosis was made postoperatively in all cases by histological results. ALs are rare and benign lesions. They usually present as an incidental finding after abdominal imaging. The diagnosis is made after the surgical removal by histological and immunohistochemical examinations.
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Affiliation(s)
- Nick Michalopoulos
- 3rd Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, 56 Papanastasiou Str, Thessaloniki, 54642 Greece
| | - Styliani Laskou
- 3rd Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, 56 Papanastasiou Str, Thessaloniki, 54642 Greece
| | - Georgia Karayannopoulou
- Pathology Department, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Leonidas Pavlidis
- 3rd Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, 56 Papanastasiou Str, Thessaloniki, 54642 Greece
| | - Ioannis Kanellos
- 3rd Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, 56 Papanastasiou Str, Thessaloniki, 54642 Greece
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11
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Sebastiano C, Zhao X, Deng FM, Das K. Cystic lesions of the adrenal gland: our experience over the last 20 years. Hum Pathol 2013; 44:1797-803. [PMID: 23618356 DOI: 10.1016/j.humpath.2013.02.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/06/2013] [Accepted: 02/08/2013] [Indexed: 11/28/2022]
Abstract
Cystic lesions of the adrenal gland are uncommon, often presenting with nonspecific clinical and radiologic findings, and are thus underrecognized. They are occasionally associated with malignant neoplasms, which can greatly mimic benign lesions and carry detrimental clinical consequences if misdiagnosed. Here we present our 20-year experience (1992-2012) with these lesions at an academic medical center. Among more than 4500 adrenal gland specimens, 31 cases of adrenal lesions with a predominant cystic component were identified in 30 patients with an age range of 34 to 86 years (median, 55.5 years) and a male/female ratio of 13:17. Macroscopic descriptions, available histologic and immunostain slides, and available radiologic records were reviewed for all included cases. Radiologic studies and gross examination correlated well, and hemorrhage (26 cases; 84%) and encapsulation (25 cases; 81%) appeared to be nonspecific radiologic/gross features shared across histologic subtypes. Microscopic review identified 12 cases (39%) of pseudocysts, 2 cases (6%) of endothelium-derived cysts, and 17 cases (55%) of epithelium-derived cysts. Among these 31 cystic adrenal lesions, 2 cases (6%) were malignant neoplasms (1 epithelioid angiosarcoma, 1 adrenocortical carcinoma). Radiologic impression and histopathologic diagnosis were concordant in 11 (73%) of the 15 cases for which radiologic records were available. This study represents the second largest case series to date on cystic adrenal lesions and presents a comprehensive review on their demographic, clinical, radiologic, and gross and microscopic pathologic features, as well as their differential diagnoses.
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Affiliation(s)
- Christopher Sebastiano
- Department of Pathology, New York University Langone Medical Center, New York, NY 10016, USA
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12
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Nerli RB, Guntaka A, Devaraju S, Patil S, Hiremath MB. Adrenal cysts: Our laparoscopic experience. J Minim Access Surg 2012; 8:145-8. [PMID: 23248442 PMCID: PMC3523452 DOI: 10.4103/0972-9941.103123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Accepted: 12/27/2011] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION: Cystic lesions of the adrenals are rare with an incidence of 0.06% in autopsies, and the most frequently found are either the endothelial cysts or the pseudocysts. We report our series of patients presenting with adrenal cysts. MATERIALS AND METHODS: The case records of patients presenting with adrenal cysts were reviewed and analyzed. Age, gender, presenting symptoms, physical examination findings, laboratory investigations and imaging records were all noted and analysed. RESULTS: During the 10-year study period, 14 patients, with a mean age of 41.36 ± 5.57 years, were diagnosed to have adrenal cysts. Laparoscopic excision of cysts was performed in three and laparoscopic adrenalectomy in the remaining eleven. CONCLUSIONS: Adrenal cysts are rare, and intervention is indicated whenever they are large (>5 cm), symptomatic, functional, and potentially malignant. Laparoscopic management of these cysts in the form of either decortication/excision is safe, effective, minimally invasive, with minimal blood loss and shorter duration of hospitalization.
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Affiliation(s)
- Rajendra B Nerli
- Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital and MRC, KLE University's JN Medical College, Belgaum, Karnataka, India
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13
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Ruiz-Rabelo JF, Gomez-Alvarez M, Sanchez-Rodriguez J, Peña SR. Complications of extrahepatic echinococcosis: Fistulization of an adrenal hydatid cyst into the intestine. World J Gastroenterol 2008; 14:1467-9. [PMID: 18322969 PMCID: PMC2693703 DOI: 10.3748/wjg.14.1467] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Echinococcal cysts are usually found in liver and lungs, but any other organ can potentially be involved. Extrahepatic disease due to hydatid cyst may develop in the abdominal and pelvic cavity, aside from in other less common locations, which may make both diagnosis and treatment more complex. We present a rare case of extrahepatic echinococcosis in a 70-year old patient with a 4-d history of dull abdominal pain, anemia within the transfusion range and fever. She underwent surgery for left renal hydatid cysts 30 years ago. After non operative treatment, imaging studies showed a calcified hydatid cyst in a retrogastric location communicating with a proximal jejunal loop. En-block resection of the mass together with the adrenal gland was performed including closure of the enteric fistula. Anatomic pathology confirmed the diagnosis of a calcified hydatid cyst of left adrenal origin. Surgery is the treatment of choice and most authors recommend removal of cyst and adrenal gland.
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