MRI of adrenal lymphangioma: a case report

A 42-year-old female admitted with non-specific abdominal pain was evaluated with abdominal sonography which detected a multiloculated cystic lesion in the left perirenal area. Her clinical history was unremarkable. Laboratory examinations revealed no abnormality. The patient was further evaluated with abdominal MR imaging which demonstrated a multiloculated, multicystic lesion at the left adrenal gland with different internal viscosities (Figure 1A). The septations between the cysts showed contrast enhancement but no nodular area was detected at septations or at the wall (Figure 1B). The patient underwent an operation of transperitoneal laparascopic adrenalectomy. The histopathological evaluation of the tumor revealed the diagnosis of lymphangioma (Figure 2).

Figure 1.

(A) T2w coronal MR image demonstrating left adrenal multiloculated cystic mass (arrows); (B) Post-contrast fat saturated T1w image showing the contrast enhancement of the septations (dashed arrows) inside of the cystic mass (arrows).

Figure 2.

Macroscopic specimen of the lymphangioma that was laparoscopically removed.

Lymphangioma is a rare, commonly asymptomatic and incidentally detected, benign cystic tumor of the adrenal gland (1-3). It is accepted as the subgroup of endothelial adrenal cyst and suggested to occur as a developmental abnormality of lymphatic channels. Laparoscopic retroperitoneal surgery may be the treatment of choice, as in the presented case.