Cystic phaeochromocytoma is a rare occurrence. We report a case of a 42-year-old woman who presented with the cardinal symptoms of phaeochromocytoma with elevated serum catecholamine levels. Radiological investigations showed a cystic mass in the right adrenal. Right adrenalectomy through a subcosal incision was performed and pathological examination concluded to a cystic phaeochromocytoma. We discuss the pathophysiology of such cyst formation as well as differential diagnoses.

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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.
  • A systematic review of 39 studies from 2000 to 2023 focused on the clinical and radiological characteristics of adrenal gland pseudocysts, analyzing data from 45 patients, primarily adult women.
  • Findings indicated that many patients were asymptomatic or experienced vague abdominal pain, with the most notable imaging result being cystic lesions with calcifications; surgical intervention was necessary in cases of compression, growth, or cancer suspicion, with a majority undergoing open surgery.
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Pheochromocytoma is a rare neuroendocrine tumor arising from adrenal medulla. Patients usually show classic triad of headache, palpitations and diaphoresis along with persistent or paroxysmal hypertension. Majority of the tumors are solid or mixed solid and cystic.

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Late-Onset Manifestations of Von Hippel-Lindau Syndrome: A Case Report.

Cureus

June 2024

Radiology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be University), Pune, IND.

Von Hippel-Lindau (VHL) syndrome is characterized by a range of tumors including phaeochromocytomas, pancreatic adenomas, cerebellar haemangioblastomas, and renal cell carcinomas. A 50-year-old male presented with a three-week history of headache. Additionally, the patient exhibited signs of hypertension.

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Benign adrenal cysts are relatively uncommon variants of all adrenal incidentalomas. When identified, most benign adrenal cysts are asymptomatic, which differentiates them from other functional adrenal lesions. There are various types of adrenal cysts, although the most common being an endothelial cyst.

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von Hippel-Lindau (VHL) syndrome (OMIM #193300) is an autosomal dominant disorder with incomplete penetrance occurring due to a mutation in the gene present on chromosome 3. We present the case of a 21-year-old male with a history of retinoblastoma presenting with intermittent headaches for one month. He was a known hypertensive and his blood pressure on presentation was 180/100 mmHg.

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