case_images: PMC10843365_01
case_images: T2W coronal MRI images of the abdomen reveal a giant cyst extending from the right sub-hepatic region upto the iliac fossa and bulging across the midline with compression and displacement of the surrounding structures. The black arrow in A shows the superiorly displaced and compressed gall bladder and curved black arrows in D, E, and F point toward the displaced right kidney into the left lumbar region below the left kidney (white arrow in F).
case_images: cureus-0016-00000051758-i01.jpg
case_images: PMC10843365_01_cureus-0016-00000051758-i01.jpg
case_images: FIG1
case_images: T2-weighted (T2W) MRI of the abdomen (Figure 1) revealed a large unilocular, thin-walled cyst, inseparable from the right adrenal and measuring 28.6 cm craniocaudally, 22.5 cm transversely, and 17.5 cm anteroposterior, extending from the right sub-hepatic region up to the right iliac fossa and bulging across the midline to the left.
case_images: T2W axial (A) and fat-saturated T1W post-contrast axial (B) and coronal (C) MRI images reveal the giant right adrenal cyst with no evidence of septations or any enhancing solid component. The displaced right kidney (white arrow in B) is seen anteroinferior to the left kidney (black arrow).
case_images: cureus-0016-00000051758-i02.jpg
case_images: PMC10843365_01_cureus-0016-00000051758-i02.jpg
case_images: FIG2
case_images: T1-weighted (T1W) post-contrast (axial and coronal) MRI images (Figure 2) revealed the giant right adrenal cyst had no septations or any enhancing solid component, although there was a severe displacement of the right-sided abdominal contents to the left.
case_images: (A) Serosanguinous lymphatic fluid with minimal blood tinge aspirated from the cyst. (B) Excised cyst wall after fluid aspiration
case_images: cureus-0016-00000051758-i03.jpg
case_images: PMC10843365_01_cureus-0016-00000051758-i03.jpg
case_images: FIG3
case_images: We aspirated around 3.5 liters of serosanguinous lymphatic cyst fluid with a minimal blood tinge (Figure 3).
case_images: (A) 4x magnification of the excised cyst wall showing cells of adrenal origin. (B) 10x magnification of the excised cyst wall. The cyst wall was lined by flattened endothelial cells with focal hemorrhages and the adrenal parenchyma was seen.
case_images: cureus-0016-00000051758-i04.jpg
case_images: PMC10843365_01_cureus-0016-00000051758-i04.jpg
case_images: FIG4
case_images: Microscopic examination showed the cyst wall lined by flattened endothelial cells with focal hemorrhage and adrenal gland parenchyma (Figure 4).