1. Presented by Peter Illei, M.D. and prepared by Kara Judson, M.D.

This 43-year-old woman had a 3.0 cm incidental right adrenal cyst noted 7 years ago. Nine months ago she was admitted with a high fever of unknown etiology and CT scan revealed a 5.6 cm right adrenal cyst. Laboratory values including testosterone levels were within normal limits. The patient complained of some weight loss and some right flank pain. The patient had lost approximately 30 pounds in the last several months. She had decreased energy, no libido, and had been treated with testosterone shots. She underwent a right laparascopic adrenalectomy. At gross exam, the adrenal was cystic, measured 6.5 x 6.2 x 3.5 cm and weighed 94.9 g. Upon sectioning, approximately 50cc of non-viscus dark yellow fluid was collected from the cyst. Serial sections showed a multilocular cystic structure of the adrenal gland with one large (~5.0 cm) cystic space largely surrounded by a thin rim of compressed cortex and multiple smaller cysts within the cortical parenchyma.

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