Endocrine Abstracts

Introduction: Primary retroperitoneal bronchogenic cysts are rarely seen. Bronchogenic cysts are mostly benign which originate from the remnants of the primitive foregut during the embryonic development.

These lesions can be seen near or inside any organ that originates from the embryonic foregut. Bronchogenic cysts are most often found in the thoracic cavity, especially in the mediastinum. Except this many distant sites, such as abdomen, retroperitoneum, left ventricle have been reported. A bronchogenic cyst, which was defined in the retroperitoneal region, was first described by Miller et al. in 1953. No specific diagnostic imaging modality is present for the preoperative diagnosis of retroperitoneal bronchogenic cysts. This is why a bronchogenic cyst may be misdiagnosed as an adrenal tumor or other retroperitoneal lesions. Definite diagnosis requires histopathological examination. Here, we report a case of a 28-year-old male with a bronchogenic cyst mimicking as an adrenal mass.

Case: A 28-year-old male was admitted to the hospital after having intermittent left flank pain. There was no significant findings in his physical examination, and in the laboratory analysis kidney and liver function test values were within normal limits. Abdomen computed tomography was performed and in the left surrenal gland a 42 × 36 mm large lesion with 38 HU density without contrast enhancement was observed. The patient was tested for hypercortisolism and pheochromocytoma. Primary hyperaldosteronism was not examined because he had no history of hypertension. After the test results the adrenal mass was considered as nonfunctional. Because of the size of the mass, the patient was operated and left adrenelectomy was performed. Macroscopically, the specimen consisted of a regular, cystic mass measuring 50 × 40 × 35 mm. It was observed that the mass was attached to the adrenal gland but not infiltrated into the adrenal parenchyma. After histopathological analysis the concise diagnosis was made as bronchogenic cyst.

Conclusion: We present an uncommon bronchogenic cyst mimicking adrenal mass in a 28-year-old male who admitted with left flank pain. Bronchogenic cysts are rare and often benign lesions. Like most adrenal lesions, bronchogenic cysts are frequently asymptomatic and diagnosed incidentally. Bronchogenic cysts should be considered in the diagnosis of lesions located in the retroperitoneal region.