Slovenská chirurgia 2/2023

Adrenal cyst imitating a liver cyst – a case report

Adrenal cysts are in the population rare. Most adrenal cysts are asymptomatic and benign, while flank pain and gastrointestinal symptoms dominate in symptomatic cysts. Cysts of the adrenal glands have been divided into four categories by histological classification: endothelial cysts, epithelial, parasitic cysts and pseudocysts. From the point of view of hormonal production are divided to functional and non-functional. Ultrasound examination can mislead adrenal cyst as the renal, liver or pancreatic cyst, hence the CT examination is considered to be a method of choice as for differential diagnostics of adrenal cysts. No generally valid recommendations for the treatment of adrenal cysts have been developed. According to some authors, a conservative procedure is also possible for small, asymptomatic and afunctional cysts, but the main method of treating adrenal cysts is surgical treatment. Any patient with a cyst larger than 6 cm in diameter, functional or potentially malignant should undergo surgical treatment. The gold standard of surgical treatment today are mini-invasive surgical procedures such as mini-invasive adrenalectomy, and in cases of hormonally inactive cysts with a low risk of malignancy, resection of the cyst wall or marsupialization with adrenal tissue-sparing resection can be performed. In our case, it was a patient with a cyst of the right adrenal gland, which mimicked a liver cyst during imaging examinations, and who was subsequently indicated for surgical treatment, in which extirpation of the cyst was performed with right-sided adrenalectomy in an open manner.

Keywords: adrenal cysts, adrenal tumors, adrenalectomy, mini-invasive adrenalectomy, adrenal cysts resection