RESUMO
Adrenal pseudocysts are rare lesions that develop within the adrenal glands, generally from vessel ectasia or from degenerative adenomas or hematomas. They are usually non-functional and asymptomatic. The reported potential malignant transformation of an adrenal cyst is ca. 7% and indicates radical excision of these masses. We report the case of a 69-year-old man with hypertension, chronic obstructive pulmonary disease, and obesity in whom microscopic hematuria was detected during a routine examination performed by his family doctor. To investigate the cause of this microscopic hematuria, the patient underwent computed tomography of the abdomen, which showed a well-defined 12-cm lesion of the left adrenal gland with calcification and necrotic components that was compressing the left kidney, pancreas, and spleen. Suspecting adrenal carcinoma, after preoperative staging, a left subcostal laparotomy was performed, with resection of the left adrenal gland, a splenectomy, and resection of the pancreatic tail. The histology showed an adrenal pseudocyst with a fibrous capsule containing amorphous eosinophilic material with calcification and cholesterol crystals. The patient's postoperative course was uneventful, and he was discharged 12 days after surgery.