44 year old man presented with painless left upper quadrant mass.
On ultrasound, there is a large anechoic lesion with thin wall in the left upper quadrant. Septations are present. The mass measures about 12.88 x 9.77 x 13.11cm. No intralesional vascularity noted. The origin of the mass could not be identified but most likely adrenal in origin.
A diagnosis of adrenal cyst was made and he was referred back to his GP with a recommendation to do CT scan abdomen.
Adrenal cysts are rare cystic masses that arise from the adrenal gland. They are usually non-functional, asymptomatic and less than 10 cm in diameter when discovered incidentally. However, giant adrenal cysts are cysts of the adrenal gland which are larger than 10 cm in diameter. They pose a diagnostic conundrum to the surgeon as localization of the origin of the cyst is very difficult.

Acknowledgement: Dr Khairul, Klinik Khairul Nor, Shah Alam