陳忠佐、林志明

國泰綜合醫院外科部泌尿科

Chung-Tso Chen, Chih-Ming Lin

Divisions of Urology, Department of Surgery, Cathy General Hospital, Taipei, Taiwan

 

Cystic lesions of the adrenal gland are uncommon. Pseudocysts are like cysts, but lack epithelial or endothelial cells. There are no specific clinical and radiologic findings. Large adrenal cysts can however present with severe abdominal pain and can be complicated by hemorrhage, rupture or infection.

    We present a case of 74-years-old female with past history of diabetes mellitus, hypertension and Parkinsonism. She suffered from headache and high blood pressure (200/100 mmHg) for about 4 months. On evaluation, abdominal echo showed a mass about 5.3cm between spleen and left kidney. Abdominal computed tomogram revealed a left suprarenal calcified mass about 5.6cm. Endocrine survey only showed elevated Dopamine, but is related to L-Dopa used for Parkinsonism. Non-functional adrenal tumor was impressed. The patient later received open adrenalectomy. Pathological examinations revealed medulla-centered lesion consisting predominantly of blood clots, fibrinoid debris and focal necrotic tissue surrounded by fibrous pseudo-capsule. The pathology diagnosis was hemorrhagic cyst (adrenal pseudocyst) and focal cortical nodular hyperplasia. The postoperative course was smooth and the patient was discharged 7 days after surgery