Giant Adrenal Pseudocyst Treated Laparoscopically; Case Report and Review of the Literature

We report a case of a giant adrenal pseudocyst, found incidentally in a 45 year old female. Her CT scan showed a 7.5cm x 7.3cm suprarenal mass and she underwent a laparoscopic transperitoneal adrenalectomy. We report this case and review the literature regarding the diagnosis and management of adrenal pseudocysts. CASE REPORT A 45 year old housewife with multiple sclerosis was dis- covered to have a large right suprarenal mass as an incidental finding on a computed tomography (CT) scan of her lumbo- sacral spine. On close questioning, she reported a vague his- tory of episodes of right flank pain for the previous 2 years. She also described episodes of flushing and lethargy which raised a suspicion of a possible diagnosis of phaeochromocy- toma. There was no prior history of trauma or malignancy. The examination was normal other than a palpable mass in the right upper quadrant. An adrenal protocol CT scan was performed revealing a 7.5cm x 7.3cm suprarenal cystic lesion with a calcified rim (Figs. 1,2). A renal or adrenal origin of the mass was diffi- cult to distinguish. Otherwise, no metastatic disease was seen. The possibility of a phaeochromocytoma was consid- ered, although these tumors normally display enhancement.