PMC5820576_01
(a-d) Ultrasound imaging examination.
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Differential diagnosis was unclear, ranging between an adrenal lesion and a pancreatic lesion (Figure 1).
(a) Intraoperative findings. (b) Final specimen after surgical resection.
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A unilocular mass sized 11.7 x 9.3 x 6.6 cm with 1.0430 cm3 total volume was revealed in close relevance to the pancreas but with the origin from the left adrenal gland and was excised within healthy borders and sent for further pathologic examination (Figures 2(a) and 2(b)).
Histological examination (Hematoxilina eosina X60).
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Histopathological findings confirmed a diagnosis of an adrenal pseudocyst (Figure 3).
Prisma chart.
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The search terms employed were "huge adrenal pseudocyst" and "adrenal pseudotumour." From 33 initially published articles in the period 2006-2017, we spotted 21 fully documentated cases according to PRISMA Statement guidelines (Figure 4). 16 articles were in English, 2 articles were in Chinese, 2 were in Spanish, and 1 article was in German.
(a) Box plot diagram showing the median age of patients appearing with adrenal pseudocysts. (b) Box plot diagram of the mean volume of the mass in patients with adrenal pseudocysts.
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The ratio between men and women was 1  :  1.2, while the median age appears to be 47.5 (SD 16.699; P=0.200) (Figure 5(a)). The median volume of pseudocysts was estimated to be 2.8126 cm3 ranging from 0.1250 cm3 to 9.86 cm3 (SD 2.7555; P=0.200) (Figure 5(b)).