Parasar Kunal, Mohan Shantam, John Aaron George, Nigam Jitendra, Anand Utpal, Jha Chandan Kumar
Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India.
Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India.
Surg J (N Y). 2022 Mar 3;8(1):e112-e116. doi: 10.1055/s-0042-1744153. eCollection 2022 Jan.
Adrenal pseudocysts are cystic lesions arising within the adrenal gland enclosed by a fibrous connective tissue wall that lacks lining cells. They can attain a huge size and pose a diagnostic challenge with a broad range of differentials including benign and malignant neoplasms. There are only a few small case series and case reports describing these lesions. We report a series of five patients who presented with "indeterminate" abdominal cystic lesions and were later on found to have adrenal pseudocyst. Four out of five patients presented with non-specific abdominal symptoms, and one patient presented with symptoms suggestive of a functional adrenal tumor. The size of these tumors ranged from 6 to 30 cm. They had variable radiological features and in two cases even a percutaneous biopsy could not establish the diagnosis. In four of these "indeterminate" abdominal masses, an adrenal origin was not suspected preoperatively. Surgical excision provided a resolution of symptoms, ruled out malignancy, and clinched the diagnosis.
肾上腺假性囊肿是起源于肾上腺的囊性病变，被缺乏衬里细胞的纤维结缔组织壁所包裹。它们可长得很大，并带来诊断挑战，鉴别诊断范围广泛，包括良性和恶性肿瘤。仅有少数小病例系列和病例报告描述过这些病变。我们报告了一组5例患者，他们最初表现为“不明”腹部囊性病变，后来被发现患有肾上腺假性囊肿。5例患者中有4例表现为非特异性腹部症状，1例患者表现出提示功能性肾上腺肿瘤的症状。这些肿瘤大小从6厘米至30厘米不等。它们具有多样的放射学特征，甚至在两例中经皮活检也未能明确诊断。在这些“不明”腹部肿块中的4例中，术前未怀疑肾上腺起源。手术切除缓解了症状，排除了恶性肿瘤，并明确了诊断。
