Objective: Benign adrenal cysts are rare lesions of the adrenal glands. Limited data are available to guide management. We aimed to describe the presentation and outcomes of patients with benign adrenal cysts. Design: Retrospective longitudinal cohort study. Methods: Consecutive patients with histologically or radiologically confirmed adrenal cysts between 1995 and 2021 were identified. Pheochromocytomas and malignancy were excluded. Results: Benign adrenal cysts were diagnosed in 92 patients (53, 57% women) at a median age of 45 years. Mode of discovery was incidental on imaging in 81 (88%), symptoms of mass effect in 9 (9.8%), and others in 2 (2.2%). Majority (89, 97%) of patients had unilateral cysts (45 right, 44 left) with a median size of 48 mm (range 4-200) at diagnosis. On imaging, most cysts were round/oval (85.4%), homogenous (83.2%) lesions with calcifications (64.0%) and no vascular enhancement (97.7%). During a median follow-up of 65 months (range 7-288), adrenal cysts demonstrated minimal enlargement (median size change 6 mm, median growth rate 2 mm/year). On hormonal evaluation, 10% (5/50 tested) had an abnormal overnight dexamethasone suppression test, and 9.5% (4/42 tested) had an abnormal case detection testing for primary aldosteronism. Patients treated with adrenalectomy (46, 50%) were younger (36.9 years vs 50.8 years, P = 0.0009) and had more rapidly enlarging cysts (median growth rate 5.5 mm/year vs 0.4 mm/year, P = 0.0002). Conclusion: Benign adrenal cysts are usually incidentally discovered, non-functional, homogenous lesions without vascular enhancement that demonstrate minimal growth. Adrenalectomy should be reserved for patients with heterogeneous lesions, abnormal hormonal evaluation, or those with mass effect symptoms.
Objective: Benign adrenal cysts are rare lesions of the adrenal glands. Limited data are available to guide management. We aimed to describe the presentation and outcomes of patients with benign adrenal cysts. Design: Retrospective longitudinal cohort study. Methods: Consecutive patients with histologically or radiologically confirmed adrenal cysts between 1995 and 2021 were identified. Pheochromocytomas and malignancy were excluded. Results: Benign adrenal cysts were diagnosed in 92 patients (53, 57% women) at a median age of 45 years. Mode of discovery was incidental on imaging in 81 (88%), symptoms of mass effect in 9 (9.8%), and others in 2 (2.2%). Majority (89, 97%) of patients had unilateral cysts (45 right, 44 left) with a median size of 48 mm (range 4-200) at diagnosis. On imaging, most cysts were round/oval (85.4%), homogenous (83.2%) lesions with calcifications (64.0%) and no vascular enhancement (97.7%). During a median follow-up of 65 months (range 7-288), adrenal cysts demonstrated minimal enlargement (median size change 6 mm, median growth rate 2 mm/year). On hormonal evaluation, 10% (5/50 tested) had an abnormal overnight dexamethasone suppression test, and 9.5% (4/42 tested) had an abnormal case detection testing for primary aldosteronism. Patients treated with adrenalectomy (46, 50%) were younger (36.9 years vs 50.8 years, P = 0.0009) and had more rapidly enlarging cysts (median growth rate 5.5 mm/year vs 0.4 mm/year, P = 0.0002). Conclusion: Benign adrenal cysts are usually incidentally discovered, non-functional, homogenous lesions without vascular enhancement that demonstrate minimal growth. Adrenalectomy should be reserved for patients with heterogeneous lesions, abnormal hormonal evaluation, or those with mass effect symptoms.
Authors: Giuseppe Cavallaro; Daniele Crocetti; Annalisa Paliotta; Antonietta De Gori; Maria Rita Tarallo; Claudio Letizia; Giorgio De Toma Journal: Int J Surg Date: 2014-11-22 Impact factor: 6.071
Authors: Piotr Major; Michał Pędziwiatr; Maciej Matłok; Mateusz Ostachowski; Marek Winiarski; Kazimierz Rembiasz; Andrzej Budzyński Journal: Pol Przegl Chir Date: 2012-04
Authors: Alaa Sada; Malke Asaad; Katherine A Bews; Geoffrey B Thompson; William F Young; Irina Bancos; David R Farley; Benzon M Dy; Melanie L Lyden; Elizabeth B Habermann; Travis J McKenzie Journal: Surgery Date: 2019-09-19 Impact factor: 3.982
Authors: Zina Ricci; Victoria Chernyak; Kevin Hsu; Fernanda S Mazzariol; Milana Flusberg; Sarah Oh; Marjorie Stein; Alla Rozenblit Journal: AJR Am J Roentgenol Date: 2013-11 Impact factor: 3.959
Authors: Andrea G Rockall; Syed A Babar; S A Aslam Sohaib; Andrea M Isidori; Salvador Diaz-Cano; John P Monson; Ashley B Grossman; Rodney H Reznek Journal: Radiographics Date: 2004 Mar-Apr Impact factor: 5.333