Momiyama Masashi, Matsuo Kenichi, Yoshida Kenichi, Tanaka Kuniya, Akiyama Hirotoshi, Yamanaka Shoji, Endo Itaru
Department of Gastroenterological Surgery, Yokohama City University, Yokohama, Japan.
J Med Case Rep. 2011 Apr 4;5:135. doi: 10.1186/1752-1947-5-135.
Adrenal pseudocysts are rare cystic masses that arise from the adrenal gland and which are usually non-functional and asymptomatic. Adrenal pseudocysts consist of a fibrous wall without an epithelial or endothelial lining. We report the case of a patient with a giant adrenal pseudocyst presenting with right hypochondralgia and high fever.
A 52-year-old Japanese man was admitted with right hypochondralgia and a chill. Abdominal computed tomography revealed a well-defined cystic mass measuring 19 cm which was located in the right adrenal region and the contents of which were not enhanced with contrast medium. Abdominal ultrasonography revealed a heterogeneously hypo-echoic lesion with a peripheral high-echoic rim. Serum hormonal levels were almost normal. Despite treatment with antibiotics, the high fever persisted. Based on these findings, we made a preoperative diagnosis of a right adrenal cyst with infection. However, the possibility of malignancy still remained. The patient underwent laparotomy and right adrenal cyst excision with partial hepatectomy in order to relieve the symptoms and to confirm an accurate diagnosis. Histological examination revealed an adrenal pseudocyst with infection. His condition improved soon after the operation.
We report a case of a giant adrenal pseudocyst with infection. Surgery is required for symptomatic cases in order to relieve the symptoms and in cases of uncertain diagnosis.
肾上腺假性囊肿是一种罕见的囊性肿物，起源于肾上腺，通常无功能且无症状。肾上腺假性囊肿由无上皮或内皮衬里的纤维壁构成。我们报告一例巨大肾上腺假性囊肿患者，其表现为右季肋部疼痛和高热。
一名52岁日本男性因右季肋部疼痛和寒战入院。腹部计算机断层扫描显示一个边界清晰的囊性肿物，大小为19厘米，位于右肾上腺区域，其内容物在注射造影剂后未强化。腹部超声检查显示一个不均匀低回声病变，周边有高回声边缘。血清激素水平基本正常。尽管使用了抗生素治疗，但高热仍持续。基于这些发现，我们术前诊断为右肾上腺囊肿伴感染。然而，恶性肿瘤的可能性仍然存在。患者接受了剖腹手术及右肾上腺囊肿切除术，并进行了部分肝切除术，以缓解症状并明确准确诊断。组织学检查显示为肾上腺假性囊肿伴感染。术后他的病情很快得到改善。
我们报告一例巨大肾上腺假性囊肿伴感染的病例。对于有症状的病例以及诊断不明确的病例，需要进行手术以缓解症状。
