Giant adrenal incidentaloma – myelolipoma (original) (raw)

Adrenal myelolipomas (AMLs) are unusual non-functioning benign tumours composed of adipose and hematopoietic tissues. It is usually diagnosed accidentally and nowadays much more frequently because of widespread use of ultrasonography, computed tomography (CT) and magnetic resonance imaging. Adrenal myelolipoma is usually unilateral and asymptomatic, though known to be associated with obesity, hypertension, endocrinological disorders and some malignancies. We present a 48 years-old female patient, obese with no medical history and a painless right-sided mass. CT scan suggested the diagnosis of giant adrenal myelolipoma. The complete preoperative laboratory exams showed a non-functioning tumour. The patient underwent open right adrenalectomy and the pathological study confirmed the diagnosis of adrenal myelolipoma. AMLs discovered incidentally and CT scan remains the gold standard of diagnosis. The open surgery approach is the suggested treatment for giant AMLs (>10cm) while the laparoscopic and robotic surgery has been used in only a few cases.