Background: Adrenal cysts are rare tumors that have a female: male predominance of 2-3:1. They are, however, rarely encountered during pregnancy but should be considered in the differential diagnosis of flank pain.
Case: A 33-year-old woman, gravida 5, para 3013, was transferred to a tertiary care center at 14 weeks' gestation with unrelenting flank pain and gastrointestinal symptoms. Ultrasound and magnetic resonance imaging identified a large mass. After failed conservation therapy, laparotomy revealed an adrenal cyst, which was excised. The pregnancy proceeded uneventfully and ended in a term delivery.
Conclusion: This is the second documented case of pregnancy associated with an adrenal cyst. Surgical excision remains the definitive therapy. Pregnancy appears unaffected by such a cyst.