Mistake in diagnosis, Rare disease
Makoto Isono, Keiichi Ito, Kenji Seguchi, Takashi Kimura, Kazuyoshi Tachi, Takako Kono, Hiroshi Shinmoto, Tomohiko Asano
Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan
Am J Case Rep 2017; 18:1034-1038
Adrenal pseudocysts are often discovered incidentally on imaging, but the diagnosis and treatment can be challenging. A case of adrenal pseudocyst with hemorrhage is presented that mimicked a solid tumor on imaging, resulting in adrenalectomy.
CASE REPORT: A 78-year-old woman was found to have a right adrenal lesion on abdominal imaging. Enhanced computed tomography (CT) showed a heterogeneously enhanced mass, and magnetic resonance imaging (MRI) showed a high-intensity T1-weighted and T2-weighed image, with an irregular enhanced margin. The imaging findings were suggestive of a solid tumor of the adrenal gland. Although full endocrine serological studies were negative, the lesion increased in size at two-year follow-up. Right laparoscopic adrenalectomy was performed, and a benign hemorrhagic adrenal pseudocyst was diagnosed histologically.
CONCLUSIONS: Adrenal pseudocyst can be associated with acute intracystic hemorrhage, and imaging will show contrast enhancement, suggesting malignancy. In such cases, surgical excision is both diagnostic and curative.
Keywords: Adrenal Gland Diseases, Diagnosis, Therapeutics