Inside of an adrenal cyst

Abstract

This is a 36-year old menstruating female who accused abdominal pain of non-specific pattern during the last days. Abdominal ultrasound and computer tomography confirmed a left adrenal mass of 6 centimetres with cystic appearance without solid elements. No other causes of abdominal pain were identified. Adrenalectomy was performed. The pre- and post-operatory panel of endocrine assessments was normal. Pathological report confirmed an endothelial cyst at the level of a normal adrenal gland. The endothelial cells are introduced in hematoxylin eosin stain at histological report (Figure I: 4X, Figure II: 40X). The immunochemistry reaction is positive for factor VIII in cyst cells of adrenal origin. (Figure III: FVIII positive immunostain in fused and cubic cells, 20X, Figure IV: FVIII in fused cells, 20X). Further on the clinical evolution was good. Adrenal cysts may be endothelial related, epithelial derived and pseudocysts. They are found in both adults and children but the level of evidence varies from cases series to cases reports. (1,2,3) The risk of malignancy or rupture are the major complications. (1) Endothelial cysts seem more frequent in women. (2) The scenario of detection may be of a typical adrenal incidentaloma or starting from non-specific local as seen here.