A prenatally detected adrenal cyst treated by adrenal-sparing surgery: case report and review of the literature

Abstract

A neonatal case of left adrenal cyst detected in utero and successfully treated by adrenal-sparing surgery is presented and discussed with review of the literature. Incidentally discovered prenatal adrenal masses present a diagnostic dilemma. Benign and malignant conditions can present as a fetal suprarenal mass. There is a wide spectrum of management modalities ranging from followup by serial sonographic scanning during pregnancy to early primary excision of the mass. We report a neonate with prenatal diagnosis of a cystic mass arising from the left adrenal gland. Postnatal excision of the mass without adrenalectomy was carried out. Frozen sections of the mass and a biopsy of the left adrenal gland confirmed the benign nature of the cyst and normal adrenal tissue. The uniloculated cyst was reported as a pseudocyst. After surgery, the recovery was uneventful, and the patient was discharged 4 days postoperatively in good condition. On the basis of this case and review of the literature, we may conclude that early primary surgical excision is recommended for either diagnosis or treatment if the results of prenatal or postnatal imaging studies are unreliable for the precise diagnosis of suprarenal mass. Adrenal-sparing surgery is recommended if pathological evaluation of frozen sections has confirmed the benign nature of the mass.

Keywords: adrenal-sparing surgery, neonates, prenatal diagnosis, suprarenal cyst