tailieunhanh - Báo cáo y học: "A giant adrenal pseudocyst presenting with right hypochondralgia and fever: a case repor"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A giant adrenal pseudocyst presenting with right hypochondralgia and fever: a case report. | Momiyama et al. Journal of Medical Case Reports 2011 5 135 http content 5 1 135 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access A giant adrenal pseudocyst presenting with right hypochondralgia and fever a case report 1 1 1 1 1 2 Masashi Momiyama Kenichi Matsuo Kenichi Yoshida Kuniya Tanaka Hirotoshi Akiyama Shoji Yamanaka and Itaru Endo1 Abstract Introduction Adrenal pseudocysts are rare cystic masses that arise from the adrenal gland and which are usually non-functional and asymptomatic. Adrenal pseudocysts consist of a fibrous wall without an epithelial or endothelial lining. We report the case of a patient with a giant adrenal pseudocyst presenting with right hypochondralgia and high fever. Case presentation A 52-year-old Japanese man was admitted with right hypochondralgia and a chill. Abdominal computed tomography revealed a well-defined cystic mass measuring 19 cm which was located in the right adrenal region and the contents of which were not enhanced with contrast medium. Abdominal ultrasonography revealed a heterogeneously hypo-echoic lesion with a peripheral high-echoic rim. Serum hormonal levels were almost normal. Despite treatment with antibiotics the high fever persisted. Based on these findings we made a preoperative diagnosis of a right adrenal cyst with infection. However the possibility of malignancy still remained. The patient underwent laparotomy and right adrenal cyst excision with partial hepatectomy in order to relieve the symptoms and to confirm an accurate diagnosis. Histological examination revealed an adrenal pseudocyst with infection. His condition improved soon after the operation. Conclusion We report a case of a giant adrenal pseudocyst with infection. Surgery is required for symptomatic cases in order to relieve the symptoms and in cases of uncertain diagnosis. Introduction In 1903 Doran attributed the first case of adrenal cyst to Greiselius 1 . In 1670 he described a 45-year-old man whose death .