Endothelial cyst of the adrenal gland: an uncommon retroperitoneal cyst

Abstract

Adrenal cysts are uncommon. Most are asymptomatic and diagnosed incidentally during a work up for abdominal pain or incidentally during imaging studies for an unrelated cause. Adrenal cysts show a spectrum of histological changes. Traditionally, adrenal gland cysts have been classified as pseudocysts, endothelial cysts, epithelial cysts, and parasitic cysts. We report a case of a 29-year-old man who presented to our hospital with history of back pain radiating to both lower limbs. During the workup of the back pain, an incidental finding of a mass displacing the left kidney was seen on MRI. Ultrasound abdomen was done and revealed a large well defined cyst in the left upper quadrant. Contrast enhanced CT was recommended and revealed a 14 × 13 × 13 cm, thin walled cystic lesion in the left quadrant. Surgical resection of the cyst was undertaken and the specimen sent for histological examination. Histopathologic examination and immunohistochemical findings were consistent with vascular (endothelial) cyst of the adrenal. Adrenal cysts are uncommon. Most are asymptomatic and diagnosed incidentally during a work up for abdominal pain or incidentally during imaging studies for an unrelated cause. Adrenal cysts show a spectrum of histological changes. Traditionally, adrenal gland cysts have been classified as pseudocysts, endothelial cysts, epithelial cysts, and parasitic cysts. We report a case of a 29-year-old man who presented to our hospital with history of back pain radiating to both lower limbs. During the workup of the back pain, an incidental finding of a mass displacing the left kidney was seen on MRI. Ultrasound abdomen was done and revealed a large well defined cyst in the left upper quadrant. Contrast enhanced CT was recommended and revealed a 14 × 13 × 13 cm, thin walled cystic lesion in the left quadrant. Surgical resection of the cyst was undertaken and the specimen sent for histological examination. Histopathologic examination and immunohistochemical findings were consistent with vascular (endothelial) cyst of the adrenal.