Adrenal lymphangioma mimicking renal cyst: a case report and review of the literature

Peri-Renal Lymphangiomatosis: A Case Report Presenting a Rare Disease at a Rarer Location

Renal lymphangiomatosis is a rare pathology wherein dilatation of perirenal, parapelvic, and intrarenal lymphatics is observed and can occur in both children and adults. It has no gender predilection and can present in unilateral and bilateral forms. Clinical symptomatology ranges from incidental findings to flank pain, hematuria, and abdominal swelling. Radiological appearances may mimic renal cysts, peripelvic cysts, perinephric abscesses, or collections. This emphasizes the importance of developing familiarity with the imaging characteristics of this rare entity. We present the case of an 11-year-old boy whose chief complaint was abdominal distension and bilateral flank pain. The radiological assessment revealed bilateral perinephric collections, which, along with clinical correlation, led to the diagnosis of bilateral peri-renal lymphangiomatosis.

Incidental adrenal hemangioma clinically suspicious for malignancy: diagnostic considerations and review of the literature

Adrenal hemangiomas are rare lesions often found incidentally during unrelated diagnostic work-up. We report a case of a 67-year-old man with history of hypertension, hyperlipidemia, anemia, arthralgia, joint swelling and unexplained weight loss, which prompted imaging studies. Computed tomography scan revealed a 5.4 cm adrenal mass. The patient had no clinical manifestations of adrenal medullary or cortical hyperfunction. Urine and plasma metanephrines and aldosterone/renin ratio were within normal range. The patient was taking prednisone for hand and ankle swelling, precluding assessment for Cushing syndrome. Given the size of the lesion, the possibility of malignancy was considered, and the patient elected for surgical management. The left adrenalectomy specimen weighed 54 g and revealed a 4.9 cm tan-brown mass with congested cut surface and a thin rim of residual adrenal gland parenchyma. Histologic examination showed thick and thin-walled vessels intermingled with adrenocortical elements at the periphery characteristic of a hemangioma. Surgical resection is the mainstay treatment for large, isolated adrenal masses to exclude malignancy and prevent retroperitoneal hemorrhage. Herein, we report a case of adrenal hemangioma, review a variety of other diagnostic considerations occurring in the adrenal gland, and highlight useful distinguishing features to assist in accurate diagnosis.

Adrenal lymphangioma presenting as a non-functional adrenal cyst

Lymphangiomas are neoplastic lesions derived from lymphatic endothelium. They are largely encountered in the head and neck region. We describe a case of an adrenal lymphangioma, an extremely uncommon cystic lesion of the adrenal and discuss the differential diagnosis, clinical, imaging, histopathologic and immunophenotypic features of this lesion.

Adrenal cystic lymphangioma presented with hypertension: a case report

Introduction:

Adrenal cystic lymphangioma is a rare benign tumor, which is nearly always asymptomatic and incidentally discovered during routine imaging work-ups or investigating other pathologies.

Case Report:

A 43-year-old female presented hypertension, which during routine work-up of her newly diagnosed hypertension an adrenal mass was discovered and after operation the pathologic diagnosis was lymphangioma of adrenal.

Conclusions:

In evaluation of adrenal masses cystic lymphangioma should be considered as a differential diagnosis.

Clinical and pathological characteristics of adrenal lymphangioma treated by laparoscopy via a retroperitoneal approach: experience and analysis of 7 cases

To describe the clinical and pathological characteristics of adrenal lymphangioma (AL) and share our experiences of the treatment of AL with retroperitoneal laparoscopic surgery. All patients pathologically diagnosed with AL were examined. The clinical and pathological characteristics, process of diagnosis, and preparation and treatment of all patients, especially patients treated with laparoscopic surgery, were summarized and retrospectively analyzed. From January 2008 to May 2014, 8 patients underwent adrenalectomies and were diagnosed with AL in our hospital. The median age was 45.5 years. All of these patients experienced a smooth adrenalectomy: 7 performed by laparoscopy via a retroperitoneal approach and 1 performed by open surgery. Five were female and the other 3 were male. These patients had unilateral adrenal lesions. Four were located on the right which to be same as the contralateral. In addition, 1 specimen was assayed by immunohistochemistry (IHC), which revealed positive results for CD31, CD34, Factor VIII-related antigen and D2-40, and negative results for cytokeratin AE1/AE3. During a brief follow up, all patients exhibited favorable results without discomfort. AL is a benign lesion with mild bio-behavior and patients are generally asymptomatic. The use of computerized tomography (CT) combined with enhanced CT has a superior advantage in diagnosis. Laparoscopic adrenalectomies that are performed via a retroperitoneal approach would be a very safe and efficient choice for AL treatment. D2-40 can be considered as a specific IHC marker in the pathological diagnosis of AL. However, pheochromocytoma and adrenal tuberculosis should be ruled out before and during the operation.

Cystic lymphangioma of the adrenal gland: report of a case and review of the literature

BACKGROUND

Cystic lymphangioma is a rare tumor of the lymphatic vessels that occurs more frequently in women. Location of this pathology can be diverse but most commonly occurs in the neck or axilla. Cystic lymphangioma originating from the adrenal tissue represents a very rare entity.

CASE PRESENTATION

We report here the case of a 38-year-old woman who was diagnosed with a cystic retroperitoneal mass. After further investigations, the patient was suspected to have a left adrenal cystic lymphangioma. She underwent successful open left adrenalectomy as curative treatment, and the diagnosis of cystic lymphangioma of the left adrenal gland was confirmed at histology. The postoperative course was uneventful.

CONCLUSION

This case report and review of the literature bring new insights into the diagnostic difficulty and management of cystic lymphangioma of the adrenal gland.