Background: Cystic lesions of adrenal glands are quite uncommon, most often diagnosed incidentally during diagnostic imaging. An adrenal cyst presenting as abdominal mass in pregnancy offers the clinician a diagnostic and therapeutic dilemma. Case: A 26-year-old primigravida at 24 weeks of gestation was referred from outside as hepatic cyst with pregnancy. Magnetic resonance imaging revealed a large, thinned-wall sessile adrenal cyst of size 20×13×12 cm. Further investigations showed urinary VMA and metanephrine to be within the normal limit. The morning blood cortisol level was 23 mcg/dL, which was in the higher range, possibly due to pregnancy. As the patient was asymptomatic, conservative treatment was planned. To reduce the cyst volume, aspiration was done. About 2 L of straw-colored fluid was aspirated under USG guidance. Cytology was normal without any malignant cells. The patient had an uneventful antenatal follow-up and delivered at term by cesarean section and 6 months postpartum laparoscopic adrenal cystectomy was done. Conclusion: Pregnancy remains unaffected by such a cyst. Although surgery remains the definitive therapy, conservative management of adrenal cyst in pregnancy may reduce both the fetal and maternal morbidity and mortality. (J GYNECOL SURG 31:238)
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References
1.
PapaziogasB, KatsikasB, PsaralexisK, et al.Adrenal pseudocyst presenting as acute abdomen during pregnancy. Acta Chir Belg, 2006; 106:722.
2.
KimBS, JooSH, ChoiSI, SongJY. Laparoscopic resection of an adrenal pseudocyst mimicking a retroperitoneal mucinous cystic neoplasm. World J Gastroenterol, 2009; 15:2923.
3.
FavoritoLA, LottFM, CavalcanteAG. Traumatic rupture of adrenal pseudocyst leading to massive hemorrhage in retroperitoneum. Int Braz J Urol, 2004; 30:35.
4.
KhanMR, AjmalS, SaleemT. Giant adrenal endothelial cyst associated with acute and chronic morbidity in a young female: A case report. Cases J, 2009; 2:8841.
