5×0.5 cm. The histopathologic finding included a thick fibrous capsule without prominent epithelial cells in most areas, a wall containing some normal adrenal cortex tissue, the center of the cavity containing hemorrhage, and foamy macrophages compatible with adrenal pseudocyst (figure 2). The patients did not complain during the

follow ups until one year after the operation. Figure 2 Adrenal tissue with fibrotic Inhibitors,research,lifescience,medical wall without prominent epithelial cells in most areas, containing hemorrhage and foamy macrophages (hematoxylin and eosin staining, original magnification x100) Discussion In previous post-mortem studies the incidence of adrenal cysts was estimated between 0.06% and 0.18% in autopsies.1,6 The most frequent subtypes of adrenal cysts are pseudocysts and endothelial cysts.3 Other subtypes including epithelial and parasitic cysts are less prevalent.2,3 Pseudocysts which are originated from adrenal medulla or cortex are surrounded by a fibrous capsule which separates Inhibitors,research,lifescience,medical the cyst from the normal adrenal tissue.1,7,8 The exact Inhibitors,research,lifescience,medical sellekchem etiology of pseudocyst formation is not clear, but they

might be formed secondary to cystic degeneration of a primary or vascular adrenal tumors, or following trauma or infection.2,5,8 It is also suggested that pseudocysts may develop as a result of loss of cellular coverage of true cystic lesions following inflammation and hemorrhage.5 Inhibitors,research,lifescience,medical There isn’t a uniform agreement about the optimal management of adrenal cysts. However, it is possible to conservatively monitor small asymptomatic and nonfunctional lesions with repeated imaging studies.7 Surgery is recommended for symptomatic and functional cysts as well

Inhibitors,research,lifescience,medical as those with sizes larger than five cm, which increases the risk of rupture and hemorrhage, or with suspicious characteristics that increases the risk of malignant lesion or complicated cystic lesions.2,3 Although recently some of surgeons choose the GSK-3 percutaneous drainage approach in the management of adrenal cysts, this approach cannot reliably differentiate between benign adrenal cyst and malignant lesions in all cases.3,5 Moreover, recurrence of the cyst may occur in some of cases, which are treated with fine-needle aspiration.3 Surgical excision of cystic lesion can also provide adequate tissue for making accurate diagnosis.3,5 Adrenal cystic lesions may enlarge enough and rupture, and become hemorrhagic in the absence of any symptoms observed in a previously healthy adult. The condition may imitate acute abdomen and result in selleck compound circulatory shock. In some cases, preoperative diagnosis may be difficult, and accurate diagnosis may be postponed till the time of exploratory laparotomy.