Case 1:

click for bigger picture

A 25 year old female presented with right sided abdominal pain and distension of one month duration. CT scan abdomen was performed. What is your diagnosis ?

__________SCROLL FOR ANSWER__________





Answer : Bilateral giant adrenal pseudocysts

Adrenal cysts are rare; most cysts are small and remain undiagnosed, or may be discovered incidentally on USG or CT, while larger lesions present with abdominal pain and swelling. Adrenal cysts are classified as neplastic (following necrosis and cystic degeneration within tumors) and non-neoplastic (endothelial, hemorrhagic or pseudocystic, epithelial and parasitic).

Pseudocysts are characterised by the absence of any endothelial or epithelial lining, and are generally filled with fresh or altered blood as a result of hemorrhage into a normal or pathologic gland. They may get encapsulated by an occasionally calcified fibrous wall. USG and CT offer precise diagnosis, revealing cystic nature and precise localization of the cysts. Hormone production causing Cushing's syndrome and an isolated association with parathyroid adenoma have been reported.

References : Lee SH, Goodacre BW, Scudamore CH. Case report : unusual appearance of a giant adrenal pseudocyst. Clin Radiol 1991; 43: 349-351. Wahl HR. Adrenal cysts. Am J Pathol 1951; 27 : 758-9.