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Large adrenal cyst

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Incidental finding in a patient known for inflammatory bowel disease, presented with right lower abdominal pain.

Patient Data

Age: 35 years
Gender: Male
ct

Large thin-walled left suprarenal cystic mass (17 cm) arising from the adrenal gland with homogeneous fluid content. No solid component or internal septation is seen. The spleen and corporeocaudal segment of the pancreas are displaced anteriorly and the left kidney inferiorly.

Circumferential wall thickening with enhancement of the terminal ileum (length around 20 cm) with ileoileal and ileotransverse fistulae, perienteric fat stranding, thickening with enhancement of the adjacent peritoneal reflections as well as an adjacent phlegmon formation with small mesenteric lymphadenopathy.

Case Discussion

CT features of a large adrenal cyst (incidental finding) in a patient known for Crohn disease complicated by ileoileal and ileotransverse fistulae with phlegmon formation.

Adrenal cysts are rare, with an estimated incidence of <1%. Four subtypes were described: pseudocysts, endothelial cysts, epithelial cysts and parasitic cysts (usually hydatid).

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