Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma
Incidental adrenal cysts are quite rare and thus can present a diagnostic conundrum for even experienced clinicians. Here, we present the case of a patient with an incidentally identified 5 cm adrenal mass. Her evaluation was notable for evidence of mild autonomous cortisol secretion and imaging fin...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-06-01
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| Series: | Clinical Medicine Insights: Endocrinology and Diabetes |
| Online Access: | https://doi.org/10.1177/11795514251345267 |
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| author | Andrew C. Hu Jesse E. Passman Heather Wachtel |
| author_facet | Andrew C. Hu Jesse E. Passman Heather Wachtel |
| author_sort | Andrew C. Hu |
| collection | DOAJ |
| description | Incidental adrenal cysts are quite rare and thus can present a diagnostic conundrum for even experienced clinicians. Here, we present the case of a patient with an incidentally identified 5 cm adrenal mass. Her evaluation was notable for evidence of mild autonomous cortisol secretion and imaging findings concerning for malignancy with possible invasion of the inferior vena cava. Adrenalectomy was performed; pathology ultimately demonstrated an adrenal cortical pseudocyst without evidence of malignancy. All patients with solid, high-density, or large adrenal tumors require further imaging for characterization and biochemical testing for hormone secretion. While simple, low-density adrenal adenomas and cysts do not require further imaging evaluation beyond non-contrast CT, mixed cystic and solid lesions or pseudocystic lesions should be evaluated similarly to solid tumors, with the caveat that pseudocysts cannot always be well-differentiated from benign cysts on imaging. All adrenal incidentalomas should be evaluated with a biochemical work-up to assess hormonal activity. Tumors suspicious for malignancy require surgical excision. Patients with benign, hormonally active tumors should be managed surgically or medically, according to their primary pathology. |
| format | Article |
| id | doaj-art-83b7133b4be74479aece574c7a9393ff |
| institution | DOAJ |
| issn | 1179-5514 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Endocrinology and Diabetes |
| spelling | doaj-art-83b7133b4be74479aece574c7a9393ff2025-08-20T03:19:27ZengSAGE PublishingClinical Medicine Insights: Endocrinology and Diabetes1179-55142025-06-011810.1177/11795514251345267Adrenal Pseudocyst Masquerading as Adrenocortical CarcinomaAndrew C. Hu0Jesse E. Passman1Heather Wachtel2Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USADepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USADepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USAIncidental adrenal cysts are quite rare and thus can present a diagnostic conundrum for even experienced clinicians. Here, we present the case of a patient with an incidentally identified 5 cm adrenal mass. Her evaluation was notable for evidence of mild autonomous cortisol secretion and imaging findings concerning for malignancy with possible invasion of the inferior vena cava. Adrenalectomy was performed; pathology ultimately demonstrated an adrenal cortical pseudocyst without evidence of malignancy. All patients with solid, high-density, or large adrenal tumors require further imaging for characterization and biochemical testing for hormone secretion. While simple, low-density adrenal adenomas and cysts do not require further imaging evaluation beyond non-contrast CT, mixed cystic and solid lesions or pseudocystic lesions should be evaluated similarly to solid tumors, with the caveat that pseudocysts cannot always be well-differentiated from benign cysts on imaging. All adrenal incidentalomas should be evaluated with a biochemical work-up to assess hormonal activity. Tumors suspicious for malignancy require surgical excision. Patients with benign, hormonally active tumors should be managed surgically or medically, according to their primary pathology.https://doi.org/10.1177/11795514251345267 |
| spellingShingle | Andrew C. Hu Jesse E. Passman Heather Wachtel Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma Clinical Medicine Insights: Endocrinology and Diabetes |
| title | Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma |
| title_full | Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma |
| title_fullStr | Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma |
| title_full_unstemmed | Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma |
| title_short | Adrenal Pseudocyst Masquerading as Adrenocortical Carcinoma |
| title_sort | adrenal pseudocyst masquerading as adrenocortical carcinoma |
| url | https://doi.org/10.1177/11795514251345267 |
| work_keys_str_mv | AT andrewchu adrenalpseudocystmasqueradingasadrenocorticalcarcinoma AT jesseepassman adrenalpseudocystmasqueradingasadrenocorticalcarcinoma AT heatherwachtel adrenalpseudocystmasqueradingasadrenocorticalcarcinoma |