Adrenal cysts are rare and form a heterogeneous group of
lesions that includes (a) parasitic cysts, (b) epithelial cysts,
(c) pseudocysts, and (d) endothelial cysts. There is evidence
(immunohistochemical and ultrastructural) that both pseudocysts
and endothelial cysts are variants of vascular cysts.
Adrenal vascular cysts account for 84% of adrenal cysts.
They are more common in women and present clinically
with abdominal pain or are incidental findings. Their imaging
features are not specific. Grossly, both types of adrenal
vascular cysts are encapsulated. Pseudocysts are unilocular,
thick-walled, and devoid of endothelial lining, whereas endothelial
cysts are thin-walled, multilocular, and lined by
endothelium. Adrenal vascular cysts probably originate from
a preexisting vascular hamartoma. The treatment of choice
is surgical excision. The prognosis is excellent.
(Arch Pathol Lab Med. 2006;130:1722–1724)
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