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case_images: Computed tomography (CT) revealing a homogenous unilocular cystic mass between the pancreatic tail and the left adrenal grand, measuring 39 mm in the largest diameter (red arrow) (A). The wall of the cystic lesion is slightly enhanced and there are no solid components or calcification (red arrow) (B).
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case_images: Computed tomography (CT) showed a homogenous unilocular cystic mass in the pancreatic tail region, measuring 39 mm in the largest diameter (Fig. 1A). The wall of the cystic lesion was slightly enhanced, and there were no solid components and calcification (Fig. 1B).
case_images: Magnetic resonance imaging. The cystic lesion shows low intensity in T1-weighted images, high intensity in T2-weighted images, and high intensity in diffusion-weighted images. In T2-weighted images, a round-shaped low intensity area, measuring 11 mm, was detected in the cystic lesion.
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case_images: Magnetic resonance imaging (MRI) revealed that the cystic lesion contents showed high intensity in T2-weighted images, low intensity in T1-weighted images, and high intensity in diffusion-weighted images (Fig. 2). T2-weighted images, a round-shaped low intensity area, measuring 11 mm, was also detected (Fig. 2). There was no connection between the pancreatic duct and the cyst on magnetic resonance cholangiopancreatography.
case_images: Endoscopic ultrasonography (EUS) revealing a cystic lesion in the region of the pancreatic tail and suggestive of internal septa (red arrow) and intramural nodular structure showing mixed low- and high-echoic areas (yellow arrow) (A). Enhanced EUS detected no enhancement in the whole lesion (B).
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case_images: Endoscopic ultrasonography (EUS) revealed a cystic lesion in the pancreatic tail region and suggested the presence of internal septa and an intramural nodular structure showing low- and high- mixed echoic areas (Fig. 3A). Enhanced EUS also found no enhancement of the whole lesion (Fig. 3B).
case_images: Laparoscopic view. Black arrow indicates a cystic lesion under the pancreatic tail (A). Black arrow indicates the cystic lesion of the left adrenal gland (B). SV, splenic vein; IMV, inferior mesenteric vein.
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case_images: A cystic mass was detected adjacent to and under the pancreatic tail (Fig. 4A). After the dissection around the cystic lesion, we identified that the cystic lesion originated from the left adrenal gland (Fig. 4B); laparoscopic left adrenalectomy was then performed as radical treatment.
case_images: Gross appearance of the resected specimen revealing an unilocular cystic lesion, measuring 42 x 40 x 32 mm (A). Histopathologically, the cystic wall consisted of fibrocollagenous tissue without endothelial and epithelial lining (H&E, original magnification x40) (B).
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case_images: The gross appearance of the surgically resected specimen revealed that the cystic lesion was unilocular, measuring 42 x 40 x 30 mm (Fig. 5A). On the histopathological examination, the cystic wall consisted of fibrocollagenous tissue without endothelial and epithelial lining (Fig. 5B).