Objectives: Standard multi-port laparoscopic adrenalectomy (LA) is considered the gold standard for benign adrenal tumors. Surgical excision provided a resolution of symptoms, ruled out malignancy, and clinched the diagnosis. In four of these “indeterminate” abdominal masses, an adrenal origin was not suspected preoperatively. They had variable radiological features and in two cases even a percutaneous biopsy could not establish the diagnosis. The size of these tumors ranged from 6 to 30 cm. Four out of five patients presented with non-specific abdominal symptoms, and one patient presented with symptoms suggestive of a functional adrenal tumor. We report a series of five patients who presented with “indeterminate” abdominal cystic lesions and were later on found to have adrenal pseudocyst. There are only a few small case series and case reports describing these lesions. They can attain a huge size and pose a diagnostic challenge with a broad range of differentials including benign and malignant neoplasms. Adrenal pseudocysts are cystic lesions arising within the adrenal gland enclosed by a fibrous connective tissue wall that lacks lining cells.
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