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Rare disease
Case report
​Primary retroperitoneal pseudocyst: beware of the hoax solid enhancing adrenal mass
  1. Matthew Farag1,2,
  2. Dennis Gyomber2 and
  3. Sam Norden3
  1. 1Urology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
  2. 2Department of Urology, Austin Health, Heidelberg, Victoria, Australia
  3. 3Department of Anatomical Histopathology, Tissupath Specialist Pathology, Melbourne, Victoria, Australia
  1. Correspondence to Dr Matthew Farag; mattyfarag{at}hotmail.com

Abstract

​We report the case of a 55-year-old male patient with an incidental finding on CT of a ‘large adrenal mass’. The mass, which was intimately related to the left adrenal, was enhancing but not metabolically active. CT showed a 40×32 mm mass adjacent to the left adrenal and medial border of the spleen, 32 Hounsfield units (HU) precontrast and 116 HU postcontrast, consistent with a solid enhancing mass. The patient had no previous history of acute pancreatitis or any history of trauma. The patient proceeded to a laparoscopic left adrenalectomy; intraoperatively, a well-circumscribed lesion was identified intimately related to the splenic artery and able to be peeled away easily from the left adrenal. The lesion was unable to be dissected from the splenic artery and consequently the splenic artery was divided in order to completely resect this lesion. Histopathology identified the lesion as a ‘non-pancreatic fibrous pseudocyst’, with a thick calcified wall, the absence of epithelial lining and widespread inflammatory change.

  • surgery
  • general surgery
  • urological surgery
  • pathology

https://doi.org/10.1136/bcr-2019-232852

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    Footnotes

    • Contributors All authors have contributed to this publication and have consented for submission to BMJ Case Reports. MF is the primary author, surgical resident assisting in the operation. DG is the urological surgeon involved and SN is the pathologist.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.