Adrenal pseudo cyst presenting as retroperitoneal lesion: a rare presentation

Abstract

Adrenal pseudocyst are cystic lesions arising from the adrenal gland and do not contain any definitive epithelial lining. These are extremely rare and very few cases are reported, representing 1-2% of adrenal incidentalomas. Patients generally have a non-specific presentation with most patients being asymptomatic and detected incidentally, while others may present with the ensuing mass symptoms in cases of large cysts. Multiple differential diagnosis may be considered for the same. Here we reported the case of a 43 year old female who presented to us with worsening pain abdomen in the left upper quadrant. An ultrasonography revealed an 8×9×9 cm cystic lesion in the region of the tail of pancreas. Subsequent CT was suggestive of a retroperitoneal cyst with multiple diagnostic possibilities owing to the many intra-abdominal structures it was found to be associated with. A definitive pre-operative diagnosis regarding the origin of the cystic swelling could not be made. A decision to remove the lesion operatively via an open approach through an upper midline laparotomy was made and eventual histopathological diagnosis confirmed it to be an adrenal pseudocyst.