{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:06:35Z","timestamp":1790863595641,"version":"4.1.0"},"reference-count":20,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,19]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Adrenal cysts are rare lesions that may coexist with, or mimic, malignant adrenal tumours. Their shared imaging characteristics may cause misdiagnosis with potentially harmful outcomes.<\/jats:p>\n                  <jats:p>\n                    We report the case of a young man who presented with several months of headaches and mild anaemia. Non-contrast CT imaging revealed a giant left adrenal cystic lesion measuring 19\u00d715\u00d715\u2009cm with indeterminate CT attenuation and internal debris.\n                    <jats:sup>18<\/jats:sup>\n                    F-fluorodeoxyglucose-positron emission tomography demonstrated low peripheral uptake favouring a benign aetiology. The multidisciplinary recommendation was for excision given the lesion size, mass effect and risk of rupture. Open adrenalectomy confirmed a benign pseudocyst. This case demonstrates the diagnostic challenges posed by giant adrenal pseudocysts and highlights the importance of multimodality imaging and multidisciplinary input to prevent misdiagnosis and ensure appropriate management.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-269118","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T13:43:25Z","timestamp":1790862205000},"page":"e269118","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Insights into diagnosis and management of giant adrenal pseudocysts"],"prefix":"10.1136","volume":"19","author":[{"given":"Assef","family":"Jawaada","sequence":"first","affiliation":[{"name":"Endocrine Surgery, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2386-5704","authenticated-orcid":false,"given":"Joseph","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Endocrine Surgery, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Klang","sequence":"additional","affiliation":[{"name":"Endocrine Surgery, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Galata","sequence":"additional","affiliation":[{"name":"Endocrine Surgery, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Whitelaw","sequence":"additional","affiliation":[{"name":"Endocrinology, King's College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9091-0512","authenticated-orcid":false,"given":"Klaus-Martin","family":"Schulte","sequence":"additional","affiliation":[{"name":"Endocrine Surgery, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"2026100106251314000_19.10.e269118.1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20555"},{"key":"2026100106251314000_19.10.e269118.2","doi-asserted-by":"publisher","DOI":"10.1093\/ejendo\/lvad066"},{"key":"2026100106251314000_19.10.e269118.3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.5489\/cuaj.8248","article-title":"Canadian urological association guideline: diagnosis, management, and followup of the incidentally discovered adrenal mass","volume":"17","author":"Rowe","year":"2023","journal-title":"Can Urol Assoc J"},{"key":"2026100106251314000_19.10.e269118.4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.humpath.2018.07.013","article-title":"Benign vascular tumors, cysts, and pseudocysts of the adrenal gland: analysis of 55 cases","volume":"82","author":"Zheng","year":"2018","journal-title":"Hum Pathol"},{"key":"2026100106251314000_19.10.e269118.5","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1530\/EJE-22-0285","article-title":"Clinical course and imaging characteristics of benign adrenal cysts: a single-center study of 92 patients","volume":"187","author":"Dogra","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"2026100106251314000_19.10.e269118.6","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa008"},{"key":"2026100106251314000_19.10.e269118.7","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1490273"},{"key":"2026100106251314000_19.10.e269118.8","article-title":"A giant hemorrhagic adrenal pseudocyst as a cause of a diagnostic dilemma","volume":"134","author":"Bobkiewicz","year":"2024","journal-title":"Pol Arch Intern Med"},{"key":"2026100106251314000_19.10.e269118.9","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1111\/1754-9485.12755","article-title":"Giant adrenal pseudocyst: A rare diagnosis","volume":"62","author":"Haines","year":"2018","journal-title":"J Med Imaging Radiat Oncol"},{"key":"2026100106251314000_19.10.e269118.10","first-page":"707","article-title":"Adrenal haemorrhagic pseudocyst as a differential for pheochromocytoma","volume":"36","author":"Kyoda","year":"2013","journal-title":"J Endocrinol Invest"},{"key":"2026100106251314000_19.10.e269118.11","doi-asserted-by":"crossref","unstructured":"Paramythiotis D , Bangeas P , Karakatsanis A , et al . Giant adrenal pseudocyst: surgical management. Case Rep Surg 2018;8473231. doi:10.1155\/2018\/8473231","DOI":"10.1155\/2018\/8473231"},{"key":"2026100106251314000_19.10.e269118.12","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.12659\/AJCR.905063","article-title":"A Case of Hemorrhagic Adrenal Pseudocyst Mimicking Solid Tumor","volume":"18","author":"Isono","year":"2017","journal-title":"Am J Case Rep"},{"key":"2026100106251314000_19.10.e269118.13","first-page":"5","article-title":"Adrenal haemorrhagic pseudocyst: rare pseudocyst of pheochromocytoma","volume":"21","author":"Nerli","year":"2018","journal-title":"Urol Case Rep"},{"key":"2026100106251314000_19.10.e269118.14","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1159\/000346754","article-title":"Giant adrenal pseudocyst mimicking adrenal cancer","volume":"91","author":"Favaro","year":"2013","journal-title":"Urol Int"},{"key":"2026100106251314000_19.10.e269118.15","doi-asserted-by":"crossref","first-page":"75","DOI":"10.14701\/ahbps.2018.22.1.75","article-title":"Adrenal pseudocyst masquerading as hepatic cyst","volume":"22","author":"Chue","year":"2018","journal-title":"Ann Hepatobiliary Pancreat Surg"},{"key":"2026100106251314000_19.10.e269118.16","doi-asserted-by":"crossref","unstructured":"Geleit RJ , Bhardwaj R , Fish M , et al . 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