BENIGN ADRENAL CYST PRESENTING IN A PREGNANT PATIENT

Cystic lesions of the adrenal gland are uncommon, most often diagnosed incidentally during diagnostic imaging or autopsy. An adrenal cyst pr esenting as a pelvic mass In pregnancy offers the clinician a diagnost ic and therapeutic dilemma. A 28-year-old black female presented for r outine obstetric care at 26 weeks' gestation and was found on examinat ion to have a 40-cm pelvic-abdominal mass. Ultrasound confirmation rev ealed the mass to be cystic and arising from the right pelvis. Laborat ory tests including hematocrit, white blood cell count, electrolytes, rapid plasma reagin (RPR), and CA-125 were within normal limits. The p atient underwent exploratory laparotomy and a 40 x 20 cm right adrenal cyst was identified and resected. Postoperatively, the patient develo ped preterm labor and delivered a 955-g infant; the infant was dischar ged home 3 months later with bronchopulmonary dysplasia and delayed de velopmental milestones. The woman was discharged home without complica tion on postoperative Day 8. Accurate preoperative determination of th e origin of a pelvic mass occurring in pregnancy is helpful in timing therapeutic intervention. Use of ultrasound and magnetic resonance ima ging (MRI) modalities can provide detailed anatomical information with out risk to mother or fetus. Conservative management of adrenal cyst i n pregnancy ma); lower the morbidity and mortality of the mother and f etus.