A 15-year Change of Adrenal Endothelial Cyst
Yung-Hao Liu M.D., Min-Jui Wu, M.D., En Meng M.D., D. Phil
Division of Urology, Department of Surgery,
Tri-Service General Hospital, National Defense Medical Center
Adrenal gland cysts are rare and often occur without any symptoms. Even with advanced imaging modalities, it is still difficult to differentiate a benign adrenal neoplasm from a malignant one. We describe a patient with asymptomatic adrenal incidentaloma. The patient was lost to follow-up until 7 years later. On resuming follow-up, an enlarged suprarenal tumor was noted on ultrasound imaging. MRI revealed a 6 × 4 cm tumor mass, and the peripheral part expressed progressive enhancement on dynamic contrast-enhanced images. Following laparoscopic adrenalectomy was performed. Adrenal cystic lesions may change with time. Routine imaging studies during follow-up are recommended, and endocrine evaluations should be performed as an initial adrenal tumor work-up. Surgery is the treatment of choice when the cyst is >6 cm in size, malignancy is suspected, or abnormal endocrine activity is present.