Adrenal gland cyst

Adrenal glands – the pair body, closed glands of the person located in close proximity to upper poles of kidneys the main function of data of structures is a producing hormones in a human body (adrenaline, noradrenaline, corticosteroids, sex hormones).

Adrenal gland cyst – high-quality, hollow, hormonal and inactive single-chamber (is more rare multichamber) the education filled with liquid, having various localization in a projection of an adrenal gland and which is in most cases clinically asimptomatichny. An adrenal gland cyst – the rare pathology of a closed gland diagnosed in a random way when performing expanded ultrasound examination of abdominal organs. At ultrasonic diagnosis the cyst of an adrenal gland has an appearance of formation of an okrugy or oval form with a smooth internal surface and accurate equal contours with echoic thin walls and anekhogenny contents. The cyst of an adrenal gland does not influence process of a producing hormones and does not change a hormonal background of an organism of the patient in general.

Cysts of adrenal glands can be various sizes. In medical practice cases when the cyst of an adrenal gland exceeded of 10 cm are recorded. The amount of cystous education influences expressiveness of symptomatology.

On morphological features distinguish 4 types of cysts of adrenal glands:

• True epithelial cyst of an adrenal gland – the cystous education covered by a cylindrical epithelium of a bast layer of adrenal glands or an epithelium of the migrating cells of a secretory segment of a kidney;
• True endothelial cyst of an adrenal gland – the cystous education which resulted from an ectasia (expansion) lymphatic and blood vessels;
• Parasitic cyst of an adrenal gland – the cystous education forming owing to an invasion of a gidatidny echinococcus;
• The pseudocyst of an adrenal gland represents the residual phenomenon after hemorrhage in healthy tissue of an adrenal gland or a tumor of gland. Such education has no epithelial vystilka, can reach the considerable sizes.

Cysts of adrenal glands meet as single, unilateral cystous educations more often. Multiple cystous defeat or bilateral change is in rare instances diagnosed.

Adrenal gland cyst: symptoms and diagnosis

At diagnosis of a cyst of an adrenal gland an important investigation phase of a new growth is determination of malignant potential of a cyst. When carrying out inspection the cyst of an adrenal gland has to be differentiated from other tumoral formations of adrenal glands and kidneys, cancer a metastasis, okolonadpochechnikovy aneurism, a retroperitoneal teratoma, a liposarcoma. At detection of a cyst of an adrenal gland diagnosis of education has to include definition of a hormonal background of an organism of the patient, a radiographic research, magnetic and resonant inspection with contrast introduction that will allow to exclude a tumor (cystous educations do not accumulate contrast).

In certain cases at cystous educations, closely adjacent to a kidney, there is a probability of diagnosing of a cyst of an adrenal gland as cysts of an upper pole of a kidney. It is reliable it is possible to distinguish true nature of education when carrying out MPT and KT.

Huge cysts of adrenal glands are difficult diagnosed. Often such new growths are in a false manner diagnosed as a pancreas pseudocyst, the true diagnosis is established only during operation.

The adrenal gland cyst in most cases proceeds asymptomatically. At achievement of the big sizes of a cyst of an adrenal gland symptoms of education can be shown as follows:

• Increase in arterial pressure (when squeezing by cystous formation of a renal artery);
• Painful feelings in a waist, a back, a side from damage of an adrenal gland;
• Feeling of squeezing in a peritoneum;
• Renal failure (at the big amount of education and squeezing of the kidney).

When diagnosing a cyst of an adrenal gland symptoms will depend on localization and the amount of education.

Adrenal gland cyst: treatment, forecasts

Statement of the correct diagnosis at suspicion of a cyst of an adrenal gland in many respects defines education treatment. As a rule, at rather small sizes (to 4 cm) cysts of adrenal glands treatment is not required. KT-monitoring of a new growth for tracking of dynamics of its development is shown to such patients regular (time in 6 months). With significant growth in a cyst of an adrenal gland the risk of development of such complications as a purulent inflammation of a cyst, a rupture of a cyst, internal bleeding increases.

Now at an adrenal gland cyst treatment by conservative techniques does not practice. Radical techniques – a cystectomy, a partial adrenalectomy are applied to effective treatment of a cyst of an adrenal gland.

Cystectomy – radical surgical excision of cystous education and its cover.

Partial adrenalectomy – removal of tumoral high-quality education with the maximum preservation of healthy fabric of gland. During such operative measure the urgent analysis of the excised drug is made for determination of adequate level of intervention.

Preservation of reserve tissue of adrenal gland provides higher standard of living (reaction to a stress), and also gives the chance to avoid replacement hormonal therapy.

Modern techniques of carrying out operation on removal of a cyst of an adrenal gland assume traditional lumbar access or laparoscopic access. The choice of a method of treatment of a cyst, and also individual indications to carrying out surgical excision of education are defined jointly by the surgeon and the endocrinologist.

Indications to carrying out removal of a cyst of an adrenal gland laparoscopic access are high-quality, hormonal and inactive cystous formations of the small sizes (from 2 to 6 cm) without invasion signs in adjacent fabrics.

Advantages of an endoscopic technique of carrying out operation on removal of a cyst of an adrenal gland are:

• Low-invasiveness of a technique (smallest mechanical damage of fabrics);
• Visualization of adrenal glands, vessels, and also the new growth under big increase;
• Smaller blood losses, than when carrying out operation by traditional lumbar access;
• Reduction of term of disability, bystry recovery after operation;
• Safety and speed of carrying out operation.

The laparoscopic technique also attracts certain risks:

• Probability of leaving of a part of a new growth at multifocal damage of an adrenal gland;
• The increased risk of a recurrence of education.

At the successful result of operation forecast favorable.