Adrenal cyst with extensive intracystic hemorrhage; observations on criteria for clinical and pathological diagnosis.

Adrenal cysts are apparently rare; a recent report of 4 instances by Adderley, Grime, and Whitehead1has brought the number of published cases to 81. According to these authors, most such cysts are clinically silent, being found incidentally at autopsy or operation for other diseases. Occasionally, some cause pain or present signs of an abdominal tumor as an indication for exploratory laparotomy. While clinical evidence of hemorrhage into such a cyst has been occasionally encountered, massive bleeding of proportions reported here is not common. The present report, therefore, deals primarily with such a case of massive intracystic hemorrhage, and with the clinical criteria which should make the observer give serious consideration to the possibility of an adrenal cyst. The pathological characteristics of the specimen in this case, as well as of two additional adrenal cysts incidentally found at autopsy, are also presented as examples of stages through which this