EURORAD ESR

Case 10112

Adrenal pseudocyst

Author(s)
Dr. Abeer Ahmed Alhelali1 , Dr.Hesham Soliman2, Dr.Lois Richard3.

(1) MBBS, Arab board of radiology and medical imaging.
(2) MD, Consultant pediatric surgeon, Prof. of pediatric surgery, Division head at SKMC.
(3) Consultant pathology/hematopathology

Sheikh Khalifa Medical City
AbuDhabi, UAE

Acknowledgements:
I would like to thank Dr. Daniela Pugh (Consultant paediatric radiology) who suggested publishing this case.

Abu Dhabi 00971 Abu Dhabi, United Arab Emirates; Email:aalhelali@seha.ae
 
Patient
male, 2 day(s)
 
 
  • Figure 1
    Ultrasound abdomen
     

    Well-defined multiloculated cystic mass in the left retroperitoneal area of the abdomen. It causes displacement of the left kidney into the pelvis.

     
    Area of Interest: Paediatric; Imaging Technique: Ultrasound; Procedure: Imaging sequences; Special Focus: Pathology;

    Doppler ultrasound shows lack of colour flow within the cystic mass.

     
    Area of Interest: Paediatric; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
  • Figure 2
    MRI abdomen and pelvis without contrast
     

    T2WI axial view shows a large cystic mass in the retroperitoneal area of the left abdomen. It has smooth margins and contains septa and a fluid level in the dependent area.

     
    Area of Interest: Paediatric; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Pathology;

    T2WI SPAIR sagittal shows soft tissue component posteriorly with fluid-fluid level in the dependant area.

     
    Area of Interest: Foetal imaging; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Congenital;

    sMRCP 3D coronal view shows large cystic mass in the left retroperitoneal area. It has smooth margins and contains septa.

     
    Area of Interest: Paediatric; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
  • Figure 3
    Gross pathology of excised mass

    Exploratory laparotomy & surgical removal of mass.

     
    Area of Interest: Paediatric; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Pathology;
     
     
  • Figure 4
    Histopathology
     

    Low power view adrenal on top with fibrous cyst wall on bottom.

     
    Area of Interest: Adrenals; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Pathology;

    High power view of cyst wall (bottom) to show that there is no epithelial lining. The lesion corresponds to a unilocular non epithelial cystic lesion of the adrenal.

     
    Area of Interest: Adrenals; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Pathology;
     
     
Well-defined multiloculated cystic mass in the left retroperitoneal area of the abdomen. It causes displacement of the left kidney into the pelvis.
 
Doppler ultrasound shows lack of colour flow within the cystic mass.
 
T2WI axial view shows a large cystic mass in the retroperitoneal area of the left abdomen. It has smooth margins and contains septa and a fluid level in the dependent area.
 
T2WI SPAIR sagittal shows soft tissue component posteriorly with fluid-fluid level in the dependant area.
 
sMRCP 3D coronal view shows large cystic mass in the left retroperitoneal area. It has smooth margins and contains septa.
 
Exploratory laparotomy & surgical removal of mass.
 
Low power view adrenal on top with fibrous cyst wall on bottom.
 
High power view of cyst wall (bottom) to show that there is no epithelial lining. The lesion corresponds to a unilocular non epithelial cystic lesion of the adrenal.
 
 
 
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