Differential diagnosis and laparoscopic resection of an adrenal pseudocyst: A case report.

Adrenal cyst Laparoscopic resection Pancreatic cyst

Journal

International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872

Informations de publication

Date de publication:
2020
Historique:
received: 28 04 2020
accepted: 26 05 2020
pubmed: 17 6 2020
medline: 17 6 2020
entrez: 17 6 2020
Statut: ppublish

Résumé

Adrenal pseudocysts are infrequent entities and definite preoperative diagnosis is difficult. We present a case of left adrenal pseudocyst, which was intraoperatively identified as having an adrenal origin and was resected using a laparoscopic approach. A 41-year-old female was referred to our hospital for examination and treatment of a cystic lesion in the pancreatic tail. Preoperative diagnostic imaging studies showed a cystic lesion with intramural nodular structure, measuring 39 mm in the largest diameter and located between the pancreatic tail and the left adrenal gland. However, the origin of the cystic lesion remained unclear, and a definite preoperative diagnosis was not established. The cystic lesion was intraoperatively identified as having an adrenal origin after the division of the loose connective tissue layer around the lesion under the laparoscopic magnified view. Laparoscopic left adrenalectomy was performed as radical treatment and the histopathological diagnosis confirmed the presence of an adrenal pseudocyst. We could not ascertain the origin of the cystic lesion from the left adrenal gland and establish a definite diagnosis based on the findings of the preoperative diagnostic imaging modalities. Laparoscopic surgery could be more advantageous than the conventional open approach as not only a minimally invasive treatment option but also as an intraoperative diagnostic tool for cystic lesions in the pancreatic tail. This case report suggests that laparoscopic surgery could be clinically useful as not only a minimally invasive treatment but also an intraoperative diagnostic tool for cystic lesions in the pancreatic tail region.

Sections du résumé

BACKGROUND BACKGROUND
Adrenal pseudocysts are infrequent entities and definite preoperative diagnosis is difficult. We present a case of left adrenal pseudocyst, which was intraoperatively identified as having an adrenal origin and was resected using a laparoscopic approach.
PRESENTATION OF CASE METHODS
A 41-year-old female was referred to our hospital for examination and treatment of a cystic lesion in the pancreatic tail. Preoperative diagnostic imaging studies showed a cystic lesion with intramural nodular structure, measuring 39 mm in the largest diameter and located between the pancreatic tail and the left adrenal gland. However, the origin of the cystic lesion remained unclear, and a definite preoperative diagnosis was not established. The cystic lesion was intraoperatively identified as having an adrenal origin after the division of the loose connective tissue layer around the lesion under the laparoscopic magnified view. Laparoscopic left adrenalectomy was performed as radical treatment and the histopathological diagnosis confirmed the presence of an adrenal pseudocyst.
DISCUSSION CONCLUSIONS
We could not ascertain the origin of the cystic lesion from the left adrenal gland and establish a definite diagnosis based on the findings of the preoperative diagnostic imaging modalities. Laparoscopic surgery could be more advantageous than the conventional open approach as not only a minimally invasive treatment option but also as an intraoperative diagnostic tool for cystic lesions in the pancreatic tail.
CONCLUSION CONCLUSIONS
This case report suggests that laparoscopic surgery could be clinically useful as not only a minimally invasive treatment but also an intraoperative diagnostic tool for cystic lesions in the pancreatic tail region.

Identifiants

pubmed: 32544825
pii: S2210-2612(20)30384-9
doi: 10.1016/j.ijscr.2020.05.082
pmc: PMC7298542
pii:
doi:

Types de publication

Case Reports

Langues

eng

Pagination

178-182

Informations de copyright

Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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Auteurs

Yuichiro Yokoyama (Y)

Department of Surgery, Douai Memorial Hospital, 2-1-11 Yokoami, Sumida-ku, Tokyo, 130-8587, Japan; Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: yyokoyama1549@gmail.com.

Yusuke Tajima (Y)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: tajimayh@hyper.ocn.ne.jp.

Izuru Matsuda (I)

Department of Radiology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: imatsudajp@yahoo.co.jp.

Kentaro Kamada (K)

Department of Gastrointestinal Medicine, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: kkamada@kantoh.johas.go.jp.

Takashi Ikehara (T)

Department of Gastrointestinal Medicine, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: ikeike@med.toho-u.ac.jp.

Toshimasa Uekusa (T)

Department of Pathology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: uekusatoshimasa@kantoh.johas.go.jp.

Hirokazu Momose (H)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: hm_lotus@yahoo.co.jp.

Satomi Yoneyama (S)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: yoneyamas-tky@umin.ac.jp.

Hiroki Sakata (H)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: ktsgjp@gmail.com.

Akio Hidemura (A)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: hidemura-tky@umin.ac.jp.

Hiroyuki Suzuki (H)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: hiroyukisuzuki@kantoh.johas.go.jp.

Masahiro Ishimaru (M)

Department of Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kanagawa, 211-8510, Japan. Electronic address: mi1@muc.biglobe.ne.jp.

Classifications MeSH