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Case Report Open Access

Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report

  • Authors:
    • Xin Huang
    • Mengyu Zhang
    • Yijun Zhan
    • Ce Chen
    • Xinhua Zhang
    • Yaozhong Xu
  • View Affiliations / Copyright

    Affiliations: Operating Room, People's Hospital of Tuanfeng, Huanggang, Hubei 438000, P.R. China, Department of Urology, People's Hospital of Tuanfeng, Huanggang, Hubei 438000, P.R. China, Department of Pathology, People's Hospital of Tuanfeng, Huanggang, Hubei 438000, P.R. China, Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, P.R. China
    Copyright: © Huang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 548
    |
    Published online on: September 23, 2025
       https://doi.org/10.3892/ol.2025.15294
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Abstract

Adrenal cysts are rare adrenal masses that are typically benign and are often incidentally discovered during imaging examinations. However, their complex imaging characteristics can lead to misdiagnosis, particularly when they closely adhere to the upper pole of the kidney, thus resembling renal cysts or cystic renal cell carcinoma (RCC). The present study describes the case of a 41‑year‑old male patient who presented with left flank pain and was initially diagnosed with a left renal cyst. Imaging examinations identified a simple renal cyst at the upper pole of the left kidney closely adhering to the left adrenal gland. The patient underwent posterior retroperitoneoscopic left renal cyst decortication and subsequent histopathological examination revealed clear cells lining the cyst wall, indicative of low‑grade clear cell RCC. Due to the discrepancy between the clinical and radiological findings and the pathology report, a multidisciplinary team was convened. An expert pathological consultation was recommended, which resulted in a revised diagnosis of an adrenal cyst. The present study highlights the diagnostic challenges in distinguishing adrenal cysts from renal cysts and RCC by imaging and histopathology. The present study also underscores the need for multidisciplinary collaboration and thorough pathological evaluation, including the use of appropriate immunohistochemical staining, to avoid misdiagnosis.
View Figures

Figure 1

Plain and contrast-enhanced CT images
of the adrenal cyst. (A) Plain CT scan showing a low-density, round
mass at the junction of the left adrenal gland. The white arrow
indicates the cyst. The blue oval outlines the left adrenal gland.
(B) Contrast-enhanced CT during the arterial phase showing no
enhancement of the cyst. The white arrow indicates the cyst. The
blue oval outlines the left adrenal gland (inverted-Y shape). (C)
Coronary CT reconstruction during the arterial phase showing the
cyst. The red arrow indicates the adrenal cyst located at the upper
pole of the left kidney.

Figure 2

H&E staining of the adrenal cyst.
(A) Irregular clear cells lining the cyst wall are shown
(magnification, ×100). (B) Clear cytoplasmic features of cells
within the cyst wall (magnification, ×200). (C) Overview of the
entire cystic structure (magnification, ×40). (D) Cyst containing
erythrocytes with clear cells in the cyst wall is shown
(magnification, ×40). (E) Fibrous tissue hyperplasia is observed in
the cyst wall (magnification, ×40). (F) Fibrofatty tissue
surrounding the cyst (magnification, ×20).

Figure 3

Immunohistochemical staining of the
adrenal cyst. (A) Cluster of differentiation 10-positive
(magnification, ×100), (B) vimentin-positive (magnification, ×100),
(C) inhibin-α-positive (magnification, ×40), (D) melan-A-positive
(magnification, ×40), (E) synaptophysin-positive (magnification,
×40), and (F) vimentin-positive (magnification, ×40) staining are
shown. The panels (A and B) represent the first immunohistochemical
stains, while (C-F) show the additional immunohistochemical
analysis.
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Copy and paste a formatted citation
Spandidos Publications style
Huang X, Zhang M, Zhan Y, Chen C, Zhang X and Xu Y: Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report. Oncol Lett 30: 548, 2025.
APA
Huang, X., Zhang, M., Zhan, Y., Chen, C., Zhang, X., & Xu, Y. (2025). Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report. Oncology Letters, 30, 548. https://doi.org/10.3892/ol.2025.15294
MLA
Huang, X., Zhang, M., Zhan, Y., Chen, C., Zhang, X., Xu, Y."Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report". Oncology Letters 30.6 (2025): 548.
Chicago
Huang, X., Zhang, M., Zhan, Y., Chen, C., Zhang, X., Xu, Y."Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report". Oncology Letters 30, no. 6 (2025): 548. https://doi.org/10.3892/ol.2025.15294
Copy and paste a formatted citation
x
Spandidos Publications style
Huang X, Zhang M, Zhan Y, Chen C, Zhang X and Xu Y: Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report. Oncol Lett 30: 548, 2025.
APA
Huang, X., Zhang, M., Zhan, Y., Chen, C., Zhang, X., & Xu, Y. (2025). Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report. Oncology Letters, 30, 548. https://doi.org/10.3892/ol.2025.15294
MLA
Huang, X., Zhang, M., Zhan, Y., Chen, C., Zhang, X., Xu, Y."Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report". Oncology Letters 30.6 (2025): 548.
Chicago
Huang, X., Zhang, M., Zhan, Y., Chen, C., Zhang, X., Xu, Y."Adrenal cyst misdiagnosed with cystic renal cell carcinoma: A case report". Oncology Letters 30, no. 6 (2025): 548. https://doi.org/10.3892/ol.2025.15294
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