Objective: To describe two cases of adrenal pseudocyst that presented as acute abdomen and shock.

Methods: Two cases of adrenal pseudocyst are presented: one patient was a 69-year-old woman who presented with shock and pain in the left hypochondrium and the other was a 23-year-old woman who complained of dizziness and pain in the left hypochondrium.

Results: US and CT evaluation showed a heterogeneous cystic mass. Blood analysis showed low hematocrit and hemoglobin levels. Surgical resection of the retroperitoneal cystic mass was performed. The pathological analysis disclosed an adrenal pseudocyst.

Conclusions: Adrenal pseudocyst is an uncommon lesion that infrequently causes symptoms and rarely presents as acute abdomen. Ultrasound and CT are the most useful diagnostic imaging methods. Treatment is by surgery if the lesion is large and symptomatic, if it cannot be clearly distinguished from a tumor, and if massive hemorrhage occurs.

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Article Synopsis
  • Adrenal masses include various abnormal growths in the adrenal gland, with pseudocysts being the most common type of cysts; there are currently no specific guidelines for their management due to their rare occurrence.
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Adrenal cysts are uncommon and usually asymptomatic, and therefore are usually incidentally discovered adrenal lesions. They have a broad pathohistological spectrum that includes pseudocysts and endothelial (vascular), parasitic, and epithelial (mesothelial) cysts. Although most adrenal cysts are benign and hormonally non-functional lesions, some can have ambiguous imaging appearances and mimic malignant adrenal neoplasms.

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