Benign vascular tumors, cysts and pseudocysts of the adrenal gland: a contemporary multi-institutional clinicopathologic analysis of 55 cases

Abstract

Benign adrenal vascular tumors, cysts and pseudocysts are a heterogeneous group of relatively uncommon entities that may pose diagnostic challenges radiologically and pathologically. However, there are only a few small cases series, systematically characterizing the clinicopathologic features of these lesions. We identified 55 cases of benign adrenal vascular tumors, cysts and pseudocysts (23 pseudocysts, 17 hemangiomas, 8 lymphangiomas, 6 angiomatous endothelial cysts and 1 arteriovenous malformation) from a multi-institutional Urologic Pathology database between 2000–2017, and retrospectively analyzed their clinicopathologic features. We found that these lesions have a female predominance and the majority are right-sided. These lesions may occur simultaneously with other adrenal tumors associated with hormonal hypersecretion. A substantial portion of pseudocysts were semi-solid or solid with no fluid collection, mimicking a solid adrenal tumor, and resulting in adrenalectomy. In addition, a small proportion of benign vascular lesions may have coexisting epithelial tumors, requiring extensive specimen sampling and thorough microscopic examination.