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CASE REPORT
A unique presentation of a complex haemorrhagic adrenal pseudocyst
  1. Ryan James Geleit1,
  2. Rakesh Bhardwaj2,
  3. David Fish3,
  4. Seshadri Sriprasad4
  1. 1Darent Valley Hospital, Dartford, UK
  2. 2Department of General Surgery, Dartford and Gravesham NHS Trust, Dartford, UK
  3. 3Department of Pathology, Maidstone Hospital, Maidstone, UK
  4. 4Department of Urology, Darent Valley Hospital, Kent, Ohio, USA
  1. Correspondence to Dr Ryan James Geleit, rgeleit{at}nhs.net

Summary

A man aged 33 years presented with a 3-day history of left-sided testicular discomfort. Clinical examination revealed a large left-sided varicocele. He was referred for a testicular ultrasound, which demonstrated a moderate left-sided varicocele and an associated large suprarenal mass. An urgent (CT) scan was arranged which confirmed this, with associated compression of adjacent structures, including the left kidney and left renal vessels. The patient was admitted 1 week following the CT scan with features of sepsis. An inpatient adrenal MRI scan suggested the presence of a large left-sided haemorrhagic adrenal cyst. This was removed surgically through a left subcostal incision. Histology confirmed there was no malignancy. The patient was discharged and a follow-up CT scan at 6 months showed complete resolution of the cyst with no further testicular discomfort. This is the first known case of an adrenal cyst presenting with a varicocele.

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Footnotes

  • Twitter Follow Ryan Geleit at @rgeleit

  • Contributors RJG gathered the relevant clinical information about the case with the aid of SS who was the consultant responsible for the patient's care. RB, who was also involved in the management of the patient, provided additional case-based information and report writing guidance. The report was constructed and written by RJG and SS. Significant additional editorial work was provided by both RB and DF.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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