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.