[Diagnosis and treatment of adrenal cyst: report of 15 cases]

Abstract

Objective: To discuss the diagnosis and treatment of adrenal cyst.

Methods: The clinical data of 15 patients with adrenal cyst, 9 males and 6 females, aged 42 (32 - 65), diagnosed and treated 1995 - 2005 were reviewed. The average size of the cyst was 5.3 cm in diameter. Nine cysts were in the left adrenal gland and 6 cysts in the right. The diagnostic accuracy rates of MR imaging, CT, and B-mode ultrasonography were 100% (4/4), 86.7% (13/15), and 73.3% (11/15) respectively. Thirteen patients underwent operation: unroofing in cyst via retroperitoneal laparoscopy (n = 9), adrenalectomy via laparoscopy (n = 1), or cystectomy via open surgery (n = 3).

Results: The average operative time of the 2 laparoscopy subgroups was (44 +/- 11) min, significantly shorter than that of the open surgery group [(75 +/- 40) min, P < 0.05]. The mean hospital stay after operation of the laparoscopy group was (5.1 +/- 1.1) days, significantly shorter than that of the open surgery group [(8.3 +/- 1.5) days, P < 0.05]. Pathological examination showed 3 cases of epithelial cyst,4 cases of endothelial cyst, and 6 cases of pseudocyst.

Conclusion: MR is much more useful in diagnosis of adrenal cyst. The indications of surgery include the presence of symptoms, suspicion of malignancy, increase in the cyst size, and detection of functioning adrenal cyst. Unroofing in cyst via retroperitoneal laparoscopy may be the standard operation in treating this disease.