Fact-sheet: Adrenal cyst


Updated on 04/17/2018 at 11:37 AM

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Definition

Rare benign tumor of the Adrenal gland.
Prevalence: 0.2%.
1 man / 3 women.
More common after age 30.
Bilateral in 10% of cases.
Several types:
- Cystic lymphangioma: chylous content, hamartomatous in nature.
- Cystic hemangioma: hematic content, often unilocular.
- Pseudocyst: no wall, often hemorrhagic in nature.
- Parasitic cyst: most often due to E granulosus infection, rare.

Clinical features

Most often an incidental finding.
Possible acute pain if hemorrhage occurs.

Ultrasound

First-line examination.
Well-defined anechoic cystic formation, with a wall that may be mildly thickened.
In cases of hemorrhagic changes, heterogeneous hyperechogenicity within the cyst.

CT

Reference examination.

- Regular contours.
- Pure fluid content (10 HU).
- Thin, regular wall if epithelial cyst.
- Thicker wall, calcifications if parasitic or post-hemorrhagic cyst.
- Wall enhancement on injection.

MRI

Rounded lesion.
Marked T1 hyposignal.
Possible T1 hypersignal if hemorrhagic.
T2 hypersignal.
Wall enhancement on injection.

Management

No follow-up required.
No treatment required.

Differential diagnosis

Pheochromocytoma.
Solid tumor but irregular wall enhancement.