Adrenal Pseudocyst: Rare Clinical Presentation and Review of the Literature

Abstract Adrenal pseudocysts are rare, non-neoplastic lesions of the adrenal gland, often discovered incidentally during imaging for unrelated reasons. Representing 32–80% of adrenal cysts, they are characterized histologically by a fibrous wall lacking epithelial or endothelial lining. Their etiology is uncertain but frequently linked to intra-adrenal hemorrhage, trauma, or degenerative changes. Most pseudocysts are asymptomatic, but large lesions may cause compressive symptoms or complications such as hemorrhage or rupture. This article presents the case of a 36-year-old woman with right hypochondrium pain due to a large adrenal pseudocyst, successfully managed by adrenalectomy. A literature review is also provided, covering epidemiology, pathogenesis, clinical presentation, diagnosis, and management. Imaging, especially CT and MRI, plays a crucial role in diagnosis and in distinguishing pseudocysts from malignant lesions. Surgical removal is indicated for symptomatic, large, or suspicious lesions, with minimally invasive approaches preferred when feasible. Early and accurate diagnosis is essential for optimal management and favorable outcomes.