Adrenal cysts are extrmely rare condition. Not a single case of adrenal cysts like this case could be referred in Korean literature. As there is a scarcity of material on this subject, this report is believed to be justified.
This housewife, 51 years of age, was first seen on May 4, 1967 at which time she complained of a lump in the left abdomen. She thought she had had vague abdominal pains and constipated bowel habits for fhese three or four years but she did not feel the lump there until one month prior to her visit. The past and family histories were not contributory.
Physical examination including pelvic was not pertinent except for a cystic filling tumor mass with smooth surface, measuring about 20 ㎝ in diameter, which located in the left abdomen and lies above the pelvic brim. It was non tender and slightly movable.
Routine laboratory examination and blood chemistry gave no clue. Upper G-I series showed no evidence of intrinsic abnormality in stomach and duodenum. The stomach was displaced to the right and upward. No widening of the duodenal loop was demonstrated to suggest a pancreatic cyst. Excretory urogram revealed lateral displacement of the left kidney and sharp deviation of the left ureter toward left. There was a moderate left pyelectasis. The preoperative diagnosis of retroperitoneal cystic tumor was made.
On May 10, 1967 laparotomy, through a long left paramedian incision disclosed the same finding and the tumor was removed intact without difficulty. The left kidney was not disturbed. Convalescence was not eventful and the patient was discharged two weeks after surgery.
Pathologic examination disclosed a Giant unilocular lymphangiomatous cyst measuring 23×18×15 ㎝ in dimension. Outside the cyst wall, bits of compressed adrenal cortex was seen and it was confirmed under microscope. Histologically, the cyst wall consisted largely of cavernous lymphangioma showing irregular mixture of various mesenchymal elements, e.q., lymphocytic aggregates, smooth musclo fivers, endothelial sproutings. and vasular channels. And these findings were discussed along the line of hamartomatous nature of the lesion in this case.
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