Pictorial Urology

162 Urology Journal    Vol 6    No 3    Summer 2009

Adrenal Lipoma Complicated by Perinephric Abscess

A 51-year-old man presented with fever, chills, and significant weight loss of 6 months’ duration. Three 
months earlier, the patient had undergone percutaneous nephrolithotomy for right-sided kidney calculus. 
Computed tomography revealed an 11.6 × 14.9 × 14.9-cm encapsulated multiseptated hypodense 
mass with enhancing walls and septa and areas of fat density and air in the right suprarenal region, 
displacing the inferior vena cava. Laparotomy revealed a cystic retroperitoneal mass adhered to the 
liver, duodenum, and transverse colon. There was a 9 × 8-cm solid mass within the cavity arising from 
the adrenal gland. Histological examination showed adrenal lipoma. The patient’s symptoms could be 
explained by the presence of right perinephric abscess, which possibly resulted in after percutaneous 
nephrolithotomy. Perinephric abscess is a rare complication of percutaneous nephrolithotomy.(1) 
Adrenal lipoma was an incidental finding complicated by perinephric abscess, which led to a presentation 
like a large tumor. Although lipomas are benign tumors, surgical excision is recommended even for 
asymptomatic lesions because of the risk of developing malignancy.(2)

Manoj Gupta, Disha Sood, Amanjeet Singh

Department of Surgical Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
E-mail: dramanarora03@yahoo.com

REFERENCES
1. Liu YD, Yuan J, Li X, Luo JT, Zeng GH, wu KJ. [Complications of minimally invasive percutaneous nephrolithotomy]. 

Zhonghua wai Ke Za Zhi. 2008;46:200-2. Chinese.

2. Lam KY, C Y Lo. Adrenal lipomatous tumours: a 30 year clinicopathological experience at a single institution. J Clin Pathol. 
2001;54:707-12.

Urol J. 2009;6:162. 
www.uj.unrc.ir