Pseudocysts of the Adrenal Gland: A Systematic Review of Existing Scientific Literature From 2000 to 2023.

Autor:	Dar SA; General Surgery, Aziz Bhatti Shaheed Teaching Hospital, Gujrat, PAK., Qayyum F; General Surgery, Jinnah Hospital, Lahore, PAK., Amir A; General Surgery and Surgical Oncology, Shaikh Zayed Medical Complex, Lahore, PAK., Khan MUU; General Surgery, Jinnah Hospital, Lahore, PAK., Asif MA; General Surgery, Ghurki Trust Teaching Hospital, Lahore, PAK., Ullah AS; General Surgery, Lahore General Hospital, Lahore, PAK., Chaudhry MJ; Pathology, Azra Naheed Medical College, Lahore, PAK., Afzaal H; Internal Medicine, Allama Iqbal Medical College, Lahore, PAK., Mehmood Qadri H; General Surgery, Lahore General Hospital, Lahore, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 30; Vol. 16 (9), pp. e70528. Date of Electronic Publication: 2024 Sep 30 (Print Publication: 2024).
DOI:	10.7759/cureus.70528
Abstrakt:	Adrenal masses are abnormal growths in the adrenal gland, comprising entities such as pheochromocytomas, adrenal adenomas, adrenocortical carcinomas, and adrenal cysts. Pseudocysts are predominant among adrenal cysts. Due to its infrequent presentation, there are no specific guidelines present in the current literature to steer its management. In such circumstances, a systematic review of the existing literature is imperative to develop comprehensive insights and evidence-based protocols. We aimed to comprehensively analyze the clinico-radiological characteristics and management outcomes of adrenal gland pseudocysts. Human adrenal gland pseudocysts identified through imaging and histopathology, as retrieved from the PubMed search engine, were included in the study. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist were used to stratify searched studies published between 2000 and 2023. A total of 39 studies were finally included, of which 36 were case reports and three case series, containing 45 patients in total. Data for clinical, radiological, histopathological, and outcome variables were collected, and descriptive analysis was carried out. All cases presented were adults with a clear female predominance of 66.67%. About 26.67% presented with no palpable mass or clinical symptoms, while 28.89% presented with vague abdominal pain. The most prevalent computed tomography (CT) finding was a cystic lesion with calcification and/or hemorrhage and/or necrosis, occurring in 17.78% of cases. Following this, a cystic lesion with only calcification was observed in 13.33% of cases, and a well-defined cystic mass/lesion was found in 11.11% of cases. The most important indication for surgery was compression effect in 44.44%, increasing size in 20.00%, and suspicion of malignancy in another 20.00% of cases. About 64.44% underwent open surgery, while 35.55% underwent minimally invasive surgery. Most patients, 95.55% of the total, had an uneventful postoperative course without any complications. Adrenal gland pseudocyst, though rare and incidental, warrants consideration in differential diagnosis as it presents with vague symptoms and sometimes no symptoms at all. Our review of existing literature highlights the importance of surgical intervention for symptomatic or potentially malignant cysts, with en bloc adrenalectomy being the preferred approach. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Dar et al.)
Databáze:	MEDLINE
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