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| | Clinical presentation | Laboratory assessment | CT scan | Pathology findings | Treatment |
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Case 1
Nigawara et al., 2009 [15] | Incidental left adrenal mass in a 68-year-old Japanese woman, with obesity and hypertension | Subclinical Cushing’s syndrome | Left adrenal tumor (9 × 7 cm) with highly heterogeneous configuration, including foci of calcification. Contrast media stained only the rim of the tumor | Vascular cyst with hyaline degeneration (lining cells were CD34 positive) within an adrenocortical adenoma. Immunohistochemical analysis of steroidogenic enzymes showed the expression of P450scc, 3βHSD, P450c17, and P450c21 | Laparoscopic left adrenalectomy |
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Case 2
Yamada et al., 2011 [16] | Incidental right renal and left adrenal tumors discovered in a 72-year-old Japanese female, with type 2 diabetes mellitus | Normal (nonfunctioning) | Right kidney: an enhanced mass, measuring 3 cm × 3 cm. Left adrenal: a well-demarcated nodule measuring 2 cm, consisting of nonenhanced and low-density areas | Right kidney: eenal clear cell carcinoma. Left adrenal: association of myelolipoma, endothelial cyst, and adrenocortical adenoma. Immunohistochemical analysis: expression of cytochrome P450c17, 3HβSD, and DHEA-sulfotransferase | Right nephrectomy and left adrenalectomy |
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Case 3
Hong et al., 2020 [17] | Incidental right adrenal mass in a 53-year-old Chinese man with type 2 diabetes | Nonfunctioning adrenal mass | A right circular low-density mass measuring (6 × 7 cm), with a multiroom separation inside the mass. The CT value is 17 HU with no significant enhancement on contrast-enhanced CT | Cystic mass composed of fibrous wall tissues with local calcification. Another mass with a fibrous capsule outside the cystic wall composed of bright and dark cells, which are arranged in acinar and flaky shapes, and a large, deformed nucleus was present in the foci. Immunohistochemistry shows that the cells stained positive for CD34, D2-40, desmin, and SMA | Laparoscopic right adrenalectomy |
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Case 4
The present case | Incidental left adrenal lesion discovered in a 40-year-old woman, with hypertension and obesity | Subclinical Cushing’s syndrome | A rounded well-defined nonenhancing hypodense lesion of the left adrenal measuring 44 × 29 mm in size, with high spontaneous density, and the absolute washout reached 50% with calcification in the wall which did not enhance after contrast injection | Endothelial cyst within an adrenocortical adenoma | Laparoscopic cystic resection and left partial adrenalectomy |
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