Abstract

Introduction: Cystic adrenals are uncommon lesions that must be distinguished from other retroperitoneal or adrenal tumours. They are a heterogeneous group and vascular adrenal cysts constitute the most common type. The vast majority of these tumours are silent; however, occasionally, they can present a great variety of symptoms such as mass effect, abdominal pain or discomfort. They are benign lesions without malignant potential that can require surgical treatment to confirm diagnosis or alleviate symptoms.

The development of imaging techniques has increased the number of lesions diagnosed incidentally. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are useful tools to evaluate these lesions as well as their relation with surrounding structures.

Material and methods: We report a vascular adrenal cyst occurring in a 75 year old man that presented abdominal pain and mass on the left side of the abdomen. Imaging techniques showed a retroperitoneal tumour with a size of 22 × 25 × 22 cm that displaced surrounding structures although without signs of invasion. Due to the symptoms and the size of the lesion, the patient underwent surgery. The postoperative period was uneventful and histological study revealed a vascular adrenal cyst.

Conclusion: Vascular adrenal cysts constitute a rare entity. Surgery is mandatory for large lesions, symptomatic patients and to confirm diagnosis.

Keywords: Adrenal vascular cyst; Pseudocyst; Adrenal incidentaloma; Adrenalectomy; Endothelial cyst