Adrenal myelolipoma: Case report with a review of the literature (original) (raw)

Adrenal myelolipoma: a case report

2021

Myelolipoma is a relatively rare benign tumor of adrenal gland. Most cases are non-functioning and asymptomatic and usually discovered during various diagnostic-imaging procedures performed for other diseases of abdomen. Cases associated with excessive hormone secretion have been reported which may constitute adrenocortical adenomas with associated myelolipomatous components. Histopathological findings are very interesting and the tumor is composed of bone marrow elements with various amounts of fatty tissue. The fat component in myelolipoma can facilitate the diagnosis by radiological examination. Here, we report a case of adrenal myelolipoma and its clinical presentation and evaluation. In this case, initially the patient presented with nonspecific abdominal symptoms. Her adrenal tumor was found incidentally and the final diagnosis was proved by histopathology. BIRDEM Med J 2021; 11(3): 231-234

Adrenal myelolipoma: A case report and review of the literature

The Japanese Journal of Surgery, 1989

A case of a 73 year old man who was preoperatively diagnosed as possibly having adrenal myelolipoma is presented herein. Adrenal myelolipoma is an uncommon benign tumor of which only 74 foreign cases and 43 Japanese cases have been previously reported in the literature dealing with surgically removed myelolipomas. The most consistent complaint of the adrenal myelolipoma sufferer is abdominal pain, caused by hemorrhaging in the tumor, and many cases are associated with obesity, hypertension and/or diabetes mellitus. There is now an increasing number of such cases being diagnosed during abdominal scanning with ultrasonography or computerized tomography for unrelated problems, whereupon the myelolipoma is usually surgically resected. With the availability of modern scanning techniques and fine needle biopsy, however, it should be possible to adopt a more conservative approach to the management of asymptomatic adrenal myelolipoma. Nevertheless, symptomatic or large tumors, must be removed since there is a high risk of spontaneous hemorrhage.

Review Articles Adrenal Myelolipoma: Diagnosis and Management

2006

Introduction: Adrenal myelolipomas are benign lesions that contain hematopoietic and fatty elements. They are usually hormonally inactive and asymptomatic until they reach large sizes. With the routine use of cross-sectional imaging, these lesions are now being discovered with increasing frequency. Materials and Methods: We performed a comprehensive review of the literature using the PubMed database containing the key word adrenal myelolipoma. Results: We identified 492 articles written from 1956 to 2006 and reviewed 93 in detail including the authors' own experience. In this review, we highlighted the salient diagnostic features of adrenal myelolipomas and offered a guide for management of these benign lesions. Conclusion: Adrenal myelolipomas may grow over time, but they can usually be followed without surgical excision. In some cases, very large myelolipomas can present with pain and can be confused with necrotic adrenal carcinomas, thus necessitating their surgical removal.

Adrenal myelolipoma: diagnosis and management

Urology journal, 2006

Adrenal myelolipomas are benign lesions that contain hematopoietic and fatty elements. They are usually hormonally inactive and asymptomatic until they reach large sizes. With the routine use of cross-sectional imaging, these lesions are now being discovered with increasing frequency. We performed a comprehensive review of the literature using the PubMed database containing the key word adrenal myelolipoma. We identified 492 articles written from 1956 to 2006 and reviewed 93 in detail including the authors' own experience. In this review, we highlighted the salient diagnostic features of adrenal myelolipomas and offered a guide for management of these benign lesions. Adrenal myelolipomas may grow over time, but they can usually be followed without surgical excision. In some cases, very large myelolipomas can present with pain and can be confused with necrotic adrenal carcinomas, thus necessitating their surgical removal.

Adrenal myelolipoma: a comprehensive review

Endocrine, 2017

Adrenal myelolipoma is an invariably benign neoplasm of the adrenal gland that is the second most common primary adrenal incidentaloma following adrenocortical adenomas. It is composed of elements of adipose tissue and extramedullary hematopoiesis. Hypotheses on stem cells and hormonal factors have been formulated regarding its pathogenesis that is still obscure. Despite its benign behavior, adrenal myelolipoma is clinically relevant as it might cause significant difficulties in the differential diagnosis of adrenal tumors. We have reviewed 420 cases reported between 1957 and 2017 on adrenal myelolipoma retrieved from PubMed and Scopus databases and also 20 of our case series to provide a comprehensive analysis of their pathology, epidemiological and clinical features. The average age for its diagnosis was 51 years, and no gender difference was observed. The average size of tumors was 10.2 cm. Congenital adrenal hyperplasia was associated to 10% of all cases analyzed, while other ad...

Myelolipoma: a rare incidentally detected adrenal lesion

Annals of Pathology and Laboratory Medicine, 2017

Adrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to frequent use of imaging studies. They are lipomatous tumours, that are usually asymptomatic and sometimes associated with endocrinological dysfunction. We present a case of middle aged gentleman, with accidentally detected adrenal mass and no hormonal disturbances. The patient was evaluated initially for fever. Laboratory investigations revealed evidence of urinary tract infection, which was conservatively managed. Ultrasound abdomen showed a hyperechoeic mass in suprarenal region with a hypoechoeic component. On further work up, MRI showed a well defined suprarenal mass with hyperintensity, possibly adrenal myelolipoma. The tumour was removed laparoscopically and histopathology revealed features of myelolipoma. The patient was discharged after an uneventful postoperative period. Adrenal myelolipomas are rare, benign tumours of adrenal gland diagnosed incidentally. Careful evaluation is important including imaging studies and endocrinological testing. Larger or symptomatic tumours can be excised surgically. Laparoscopic resection is a safe procedure in tumours considered for surgery, with favourable patient outcome.

[Adrenal myelolipoma. Report of a case and review of the literature]

PubMed, 1996

Objectives: Herein we describe an additional case of myelolipoma of the adrenal gland, an uncommon tumor of the adrenal cortex, that had been incidentally discovered during abdominal US evaluation of the biliary tree. The clinical features, diagnosis and treatment of the condition are discussed. Methods: Surgical treatment of the biliary tree and myelolipoma was performed through a Chevron transversal incision during the same surgical session. Results: Surgery achieved good results and the postoperative course was unremarkable. Conclusions: Myelolipoma is a benign nonfunctioning tumor of the adrenal cortex comprised of adipose and hematopoietic tissue. It is usually asymptomatic and incidentally discovered during diagnostic evaluation for other pathologies. The diagnosis is made by US, CT and MRI. There is no agreement on whether surgical treatment is warranted.

Adrenal myelolipoma :Incidentally discovered mass

International Journal of Surgery and Medicine, 2017

Introduction: Myelolipoma is a rare benign tumour of the adrenal gland, usually asymptomatic, unilateral and nonfunctioning. It is composed of a variable mixture of mature adipose tissue and hematopoietic elements. Widespread use of imaging modalities has increased the frequency of detection. Case presentation: We report a case of adrenal myelolipoma in a 55-years-old male of Indian origin, who presented with pain in the right flank. Physical examination revealed an intra-abdominal mass. Contrast-enhanced computed tomography (CECT) scan of the abdomen showed a well-defined, round lesion in right suprarenal region with heterogeneous attenuation. The patient was subjected to right adrenalectomy, and postoperative course was uneventful. The histopathological examination of the mass confirmed this as adrenal myelolipoma. Conclusion: Mostly adrenal lipoma is discovered as "incidentaloma" but warrants thorough diagnostic study. Imaging and biochemical assay are useful for planning best treatment modality in a particular case to minimise postoperative complications and assuring fast recovery.

Case Report: An incidentaloma that catches your eye - adrenal myelolipoma

F1000Research, 2017

Background: Adrenal incidentaloma refers to the incidental finding of a tumor in the adrenal gland, where nonfunctional forms are the most common variant. Myelolipoma is a rare (0.08-0.4%) occurrence characterized by adipose and hematopoietic tissue. The aim of this case report is to describe the diagnosis and appropriate management of a myelolipoma in an asymptomatic patient, which was originally considered an incidental hepatic hemangioma prior to being identified as a giant adrenal adenoma. Case description: The patient was a 54 year old obese female with a recent diagnosis of diabetes type II and dyslipidemia with recent ultrasound imaging suggestive of a hepatic hemangioma. An MRI was performed revealing a 7x6cm lesion in the right adrenal area indicating a giant adrenal adenoma. An adrenalectomy was performed without complications. The pathology report identified a myelolipoma. Discussion: The incidence of myelolipoma has recently increased due to advances in radiological tech...

Adrenal myelolipoma: a report of three cases and review of literature

JPMA. The Journal of the Pakistan Medical Association, 2009

Adrenal myelolipoma is a rare and benign tumour composed of mature adipose tissue and haematopoietic elements that resemble bone marrow. It is mostly discovered incidentally on imaging of abdomen done for non adrenal related reasons or at autopsy. Usually asymptomatic, but has been reported to present with symptoms such as flank pain resulting from tumour bulk, necrosis or spontaneous retroperitoneal haemorrhage. Symptomatic tumours, growing tumours or tumours larger than 10 cm should be excised surgically. We report cases of 3 male patients presenting with flank pain and upper pole renal masses. All three were treated surgically with adrenalectomy. Myelolipoma was confirmed in all three on histology.