Hemorrhagic adrenal pseudocyst: laparoscopic treatment

The incidence of adrenal hemorrhagic pseudocyst is very low. A total of 613 adrenal cysts and 85 hemorrhagic pseudocysts have been reported. A laparoscopically diagnosed and resolved case is presented here, together with the current diagnostic and therapeutic procedures.

A 40-year-old woman was admitted because of an asymptomatic nonfunctional right adrenal tumor. Right laparoscopic adrenalectomy was performed, 8-cm cyst which found an with thick walls and organized hematic content. The postoperative course was uneventful. Follow-up was 14 months. The pathology was an adrenal hemorrhagic pseudocyst.

A total of 56% of adrenal cysts are pseudocysts. One third of them have hematic content. They may present as an asymptomatic finding with nonspecific symptoms or as a hormone secreting or complicated tumor. Their vascular etiology is not yet totally accepted. There is a tendency for intracystic bleeding. it is advisable to evaluate the hormonal profile and morphologic characteristics in all cases. Treatment options include needle aspiration, percutaneous drainage, and cyst or gland resection. Laparoscopic excision should be evaluated.