Although most cystic lesions of the adrenal gland are benign, some malignant tumors of the adrenal may masquerade as a benign-appearing cyst.
A cystic lesion should be distinguished from focal cystic degeneration in an adrenal tumor.
Cystic lesions of the adrenal include:
(1) pseudocyst (without a cell lining, usually secondary to hemorrhagic or ischemic degeneration within an adrenal tumor)
(2) endothelial (angiomatous or lymphangiomatous with endothelial cell lining)
(3a) embryonal rest
(3b) true glandular cysts (with a epithelial cell lining)
(3c) cystic adrenal neoplasm (see below)
Adrenal tumors which may present as a cystic neoplasm include:
(1) adrenocortical carcinoma
(2) adrenocortical adenoma
(4) metastatic carcinoma
Foci of tumor in a cystic adrenal neoplasm may be small so extensive sampling of the cyst wall must be performed before a neoplasm is excluded.
An adrenal cyst may be:
(2) symptomatic due to compression of adjacent structures
(3) symptomatic from hormone production
(4) associated with abdominal pain
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Specialty: Endocrinology, Clinical Laboratory, Hematology Oncology