Clinical case: large cystic mass of the left adrenal gland

Abstract

Aim. A clinical case of a non-functioning tumor of the adrenal gland, its diagnosis and treatment.Materials and Methods. Histological preparations were stained with hematoxylin and eosin, photographed at 200 magnification.Results. Adrenal cysts are benign neoplasms that are hormonally inactive and can be asymptomatic for a long time. They are often discovered incidentally during an ultrasound or CT scan. Prior to the improvement of diagnostic methods, formations such as adrenal cysts were extremely rare. To date, there is a trend towards a steady increase in the frequency of adrenal tumors detected incidentally and is about 6–10%. Hormonally inactive adrenal tumors usually do not require surgery, but there are clinical situations in which surgery is necessary. As an example of a disease, a clinical case is given below.Patient P., 39 years old, was hospitalized in the urology department from 12/13/2021 to 12/24/2021 with a diagnosis: D35.0 Benign neoplasm of the adrenal gland (cyst of the left adrenal gland). Upon admission, there were complaints of aching pain in the left lumbar region.He considers himself ill for several years, was treated for another disease, an ultrasound in 2018 accidentally revealed a neoplasm of the adrenal gland on the left. At the last ultrasound control, an active growth of the neoplasm was detected, for this reason he was sent for surgical treatment to the urological department of RCH 1.Surgery was performed in the hospital by laparoscopic excision of a cyst of the left adrenal gland under endotracheal anesthesia. The adrenal gland was sent for post-mortem examination, the results are presented below.The wall of the cystic formation is represented by cells of the cortical layer of the adrenal gland, corresponding to the cells of the glomerular zone. The cells are large with abundant light cytoplasm and a monomorphic nucleus. In the wall of cyst there are foci of hemorrhages and accumulations of hemosiderin pigment. Outside, the cystic formation is surrounded by a fibrous capsule.Conclusion. This paper presents an analysis of a large adrenal cyst. It is important to pay attention to the fact that this incidentaloma was asymptomatic, without any clinical signs and hormonal activity. Incidentalomas are often «silent», so it is extremely difficult to identify them, but the likelihood of degeneration into a malignant tumor is high.