Cysts of the adrenal glands are rare and comprise:
- hemorrhagic (pseudocyst),
- parasitic cysts.
Endothelial cysts can be multi-septated with fluid-fluid levels from old hemorrhage. Thickened irregular septa with strong enhancement should warrant further diagnostic work-up to rule out malignancy.
Pseudocysts (39%) occur after hemorrhage into the adrenal gland. They can be large and can cause pain to the patient.
Rarely parasitic cysts occur (7%).
Cysts of the adrenal glands are calcified in 50% of cases, and 80% of cases occur unilaterally. Therefore, an adrenal gland insufficiency is extremely rare.
The imaging morphology of adrenal gland cysts is the same as that of common renal cysts. They reveal low SI on T1-weighted images, high SI on T2-weighted images and should not reveal contrast enhancement after gadolinium injection.