What Is an Adrenal Cyst?

Adrenal cysts can range in size from a few millimeters to more than 20 centimeters, mostly unilateral, with bilateral cysts accounting for 8% to 10%. Most clinically asymptomatic, and by accident, a few larger adrenal cysts can produce compression symptoms. When adrenal cysts are large, non-specific symptoms such as lumbar abdominal pain and gastrointestinal discomfort may occur due to compression of surrounding organs. A few patients may have acute abdomen due to cyst rupture and bleeding, which was only discovered during surgical exploration.

Basic Information

English name

adrenal cyst

Visiting department

Urology

Common locations

kidney

Common symptoms

Abdominal mass, hypertension, low back pain, hematuria, and adrenal disorders

Adrenal cyst clinical manifestations

The main symptoms include abdominal mass, hypertension, low back pain, hematuria, and adrenal hormone disorders. Can be divided into the following four types:

Endothelial cyst

It accounts for 45%, and is divided into lymphoma type and hemangioma type. The lining of the cyst wall is characterized by smooth and flat endothelial cells.

2. Pseudocyst

39%, mainly due to adrenal tissue or intratumoral bleeding, but also due to cystic degenerative changes in the tumor, the cyst wall is composed of dense fibrous tissue without epithelial lining. Scholars believe that pseudocysts are most common in clinical practice.

3. Epithelial cyst

It accounts for 9%, including embryonic cysts, adrenal cystadenomas, true or retention cysts, and the inner wall is lined with glandular epithelial cells.

4. Parasitic cyst

7%, with hydatid cysts as the most common, showing wall thickness, calcification, and visible head segments.

Adrenal cyst diagnosis

Except for a few tumor-derived adrenal cysts, adrenal cysts do not affect adrenal function, and laboratory tests usually have no obvious abnormal changes. Therefore, the diagnosis of adrenal cysts is mainly based on imaging examinations. If the cysts are small, the diagnosis is more difficult. The diagnosis of large cysts, whether by color Doppler ultrasound or CT, may be confused with cystic lesions of surrounding organs such as liver cysts, kidney cysts, and pancreatic cysts. In addition, adrenal cysts are rare lesions that are easily ignored by doctors and are one of the causes of misdiagnosis. Therefore, it is also necessary to consider whether the cystic lesions of the upper abdomen are derived from the adrenal glands. Ultrasound is the preferred method of examination, which is economical, painless and safe, and can greatly increase the diagnosis rate. It also provides patients with the best opportunity for diagnosis and treatment. Contrast-enhanced CT is a more accurate method for diagnosing adrenal cysts. If the source of the cyst is unclear, surgical exploration may be considered.

Adrenal Cyst Treatment

Adrenal cysts are mostly benign and rarely have endocrine functions. The treatment method depends on the patient's symptoms, the size of the cyst, and pathological changes.

1. For <3cm, cysts without clinical symptoms and endocrine function can be left untreated.

2. For those who have symptoms of mass compression, those with a cyst diameter> 5cm or hydatid cysts or neoplastic cysts need to be treated as soon as possible.

3. For asymptomatic simple cysts with a diameter of less than 4cm, clinical observation can be continued, such as enlargement or symptoms before surgery.