Cystic lesions of the adrenals: diagnosis and management

Until recently, adrenal cysts were diagnosed at surgery or autopsy. Current imaging methods allow accurate preoperative diagnosis in symptomatic patients and may obviate surgery in the asymptomatic. Eighteen cystic lesions of the adrenal glands are described. Computed tomography was the most useful diagnostic test. Many cysts had typical appearances of a thin-walled, fluid-filled lesion with or without thin septa and mural calcification. Atypical features included central densities, which may be characteristic of intracystic hemorrhage, and wall thickening which should initiate a search for endocrinopathy and tumor.