Transperitoneal laparoscopic excision of a giant adrenal lymphangioma: a step-by-step approach

Figures

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  Figure 1.. (A) Axial post-contrast image demonstrating septal enhancement. (B) Axial T1-weighted image showing predominantly hypointense cysts with a central hyperintense focus suggestive of a hemorrhagic component. (C) Axial T2 fat-suppressed image demonstrating hyperintense signal consistent with cystic/fluid content, without evidence of fat. (D) Axial T2-weighted image showing high signal intensity of the cysts, with central low signal corresponding to hemorrhagic content. (E) Coronal T2 post-contrast image demonstrating septal enhancement without suspicious solid soft tissue component. (F) Coronal T2-weighted image showing multiseptated cysts with high signal intensity (fluid) and central low signal representing hemorrhagic component. (G) Ultrasound image demonstrating a low-echogenicity, septated lesion with a thin wall, consistent with cystic content.

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  Figure 2.. (A) Intraoperative finding was well-circumscribed polycystic adrenal mass. (B) Dissection along IVC, the adrenal vein was identified, clipped, and divided in a controlled manner. (C) Adrenal specimen with multiple cystic spaces containing yellow material.

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  Figure 3.. (A) A microscopic image showing a multicystic lesion (star) within the adrenal gland. The adrenal cortex (green arrow) and medulla (black arrow) can also be seen (hematoxylin and eosin stain, ×100 magnification). (B) A magnified microscopic image showing the benign endothelial lining of the lymphangioma (arrows) (hematoxylin and eosin stain, ×100 magnification).