Laparoscopic Treatment of the Largest Mesothelial Adrenal Cyst in Literature

Abstract

Raffaele Porfidia, Maria Giovanna Ciolli, Pietro Picarella, Simona Grimaldi, Nicola Castaldo and Sergio Grimaldi

Introduction: Adrenal cyst lesions are rare, with varying etiology, with unspecified symptomatic kit and instrumental diagnosis not simple if of large size. The directions for surgical treatment are well defined.

Clinical Case: A 28-year-old patient complained of abdominal swelling, slight dyspnea, pain in the right flanking region associated with a lack of weight loss despite voluntary diet. He practices a TC and RM abdomen. That point out a cystic lesion of 30x21x38 cm but do not clarify the origin. He is subjected to laparoscopic surgical treatment which allows to clarify the peritoneal background of cysts, its drainage and removal. Histological examination confirms the mesothelial nature of cysts. The TC abdominal control at a distance of six months points out the correct localization of the abdominal organs, previously moved to the left, and the right surreal leftover.

Conclusions: Surgical treatment allows to clarify diagnostic doubts in case of large cystic lesions and to carry out a radical therapy. The removal of only cysts or the entire adrenal gland is controversial. The laparoscopic approach, if possible, is preferable as it guarantees the same result with faster recovery times and less risk of site infection or surgical wound.

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