Giant adrenal incidentaloma – myelolipoma (original) (raw)
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Laparoscopic excision of a giant adrenal myelolipoma and review of the literature
African Journal of Urology
Introduction: Adrenal myelolipoma is a rare benign tumor. It is usually asymptomatic with variable sizes, where the small lesions are usually managed conservatively and the large and symptomatic ones indicate open or laparoscopic adrenalectomy. Observation: A 45-year-old obese male patient presented with an accidentally-discovered right adrenal mass during abdominal sonographic examination. The mass was clinically-palpable in the right lumbar region. Abdominal computed tomography described a well-circumscribed lesion displacing the right kidney downwards with compression and displacement of the inferior vena cava. It was heterogeneous with 16 cm × 14 cm × 8 cm dimensions and low attenuation appearance. Adrenal myelolipoma was suspected and the patient was counseled for the laparoscopic approach with high possibilities of conversion to open surgery. Laparoscopic excision was done by expert surgeons with demanding dissection from the surroundings, especially the liver and inferior vena cava, but, the mass was successfully removed. The postoperative course was short and uneventful. Histopathological examination confirmed the diagnosis of adrenal myelolipoma.
Management of an incidentally found large adrenal myelolipoma: a case report
Cases Journal, 2009
Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue. Most lesions are small, unilateral and asymptomatic, discovered incidentally at autopsy or on imaging studies performed for other reasons. We would like to present a case report of this rare tumour. Cross-sectional imaging is helpful in making a pre-operative diagnosis. The size of the lesion should be a criterion for surgical intervention.
Giant Adrenal Myelolipoma: Is Laparoscopic Resection Possible?
2020
Background: Myelolipoma is a benign and uncommon tumor of the adrenal gland. The majority is small and asymptomatic and is diagnosed incidentally. However it can be large and produce symptoms. The laparoscopic adrenalectomy is the gold standard for its treatment but can be challenging if the lesion is big because of technical aspects and the associated malignancy risk. Case Report: We present a case of an asymptomatic 37 years old man, with past history of arterial hypertension, that performed an abdominal ultrasound that showed a huge mass on the right adrenal gland with 98×85×96 mm, consistent with a myelolipoma. The abdomino-pelvic tomography confirmed the diagnosis and the functional study revealed a marginal elevation of plasmatic nor-adrenaline and catecholamines. The MIBG scintigraphy was normal. The lesion was removed by laparoscopy. Conclusion: The giant adrenal myelolipoma is a rare tumor. Laparoscopic adrenalectomy has become the gold standard in management of most adrenal masses. Even for giant adrenal masses, it can be done in a safe way, provided that is performed by an experienced laparoscopic team.
International Journal of Endocrinology and Metabolic Disorders, 2019
Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue. Most lesions are small, unilateral and asymptomatic, discovered incidentally at autopsy or imaging studies performed for other reasons [1]. The incidence of Adrenal incidentalomas is at least 2% in the general population [2]. The prevalence of finding an adrenal myelolipoma from an incidentaloma is very small. In autopsy studies, the incidence of adrenal myelolipoma is reported as being 0.08 to 0.4% 1 with a male-to-female ratio of 1:1. No other documented case of Adrenal Myelolipoma was ever reported in our institution and only 1 published case of Adrenal Myelolipoma locally [3]. The present case is a 78-year old Filipino man who on executive checkup had an incidental finding of adrenal mass. Biochemical evaluation revealed that this was a non-functioning adrenal mass. Further evaluation including MRI of the adrenal gland showed a right suprarenal mass lesion with enhancing solid and fat components consistent with Myelolipoma. Since population based studies have limited data regarding the epidemiology of Adrenal myelolipoma, we are reporting this case to help future research studies. Due to the large size of the tumor and the risk of retroperitoneal bleeding, the patient agreed to an Elective Laparoscopic Adrenalectomy
Diagnosis and Management of a Large Adrenal Myelolipoma
International Journal of Recent Surgical and Medical Sciences
Adrenal myelolipoma is a rare condition. Although benign in nature, these tumors can increase in size and cause a mass effect to nearby structures presenting as abdominal distension and pain. In 90% of cases, adrenal myelolipomas are unilateral. However, the real challenge in management is when bilateral adrenal myelolipoma is present. Herein, we present a case of a 51-year-old male Caucasian patient with bilateral adrenal myelolipoma. The patient had a large left adrenal myelolipoma (23 × 13 cm) and a small one on the right (4.4 × 4 cm). We opted for an open left adrenalectomy due to classical features on computed tomography scan and the mass effect of the tumor.
Adrenal myelolipoma: To operate or not? A case report and review of the literature
International journal of surgery case reports, 2014
Myelolipoma is a rare, benign neoplasm that predominantly occurs in the adrenal gland and is composed of mature adipose tissue and scattered islands of hematopoietic elements. Although usually small and asymptomatic, there are some cases of adrenal myelolipoma that cause symptoms such as chronic pain. Elective surgery can prevent a more severe symptom presentation and life threatening progression while also allowing accurate diagnosis in patients with tumors larger than 6cm. This report presents an unusual case of a 28-year-old female who suffered with chronic pain from a growing left-sided adrenal myelolipoma. Without the financial means for additional testing along with many symptoms warranting a high suspicion for malignancy, this patient decided to have the mass surgically excised, which was both diagnostic and curative. For this specific patient, surgery was the most cost effective option, as well as both diagnostic and curative. Surgery can also prevent complications such as s...
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 rare benign tumour managed laparoscopically: Report of two cases
Journal of Minimal Access Surgery, 2009
Adrenal Myelolipoma is a rare benign neoplasm composed of mature adipose tissue and a variable amount of haemopoietic elements. Most lesions are small and asymptomatic, discovered incidentally during autopsy or on imaging studies performed for other reasons. Two cases of myelolipoma are presented here, where the tumours were hormonally inactive, but presented with abdominal symptoms and were managed by laparoscopic adrenalectomy.
Bilateral Giant Adrenal Myelolipoma: A Case Report
2016
Myelolipomas as the name itself suggests are tumors consisting of myeloid tissue and lipomatous tissue in variable proportion. Though rare, these tumors are usually confined to retroperitoneum with adrenals being the most common site. Adrenal myelolipoma (AML) is a rare benign tumour with reported incidence being less than 0.5%. Usually these tumors are detected incidentally on imaging done for some other reasons and most of the times they are unilateral and small. When small these tumors are mostly asymptomatic and hormonally inactive. Giant and bilateral adrenal myelolipomas are very rare tumors. We here report a rare case of bilateral giant adrenal myelolipoma in a 47 year old male who presented to us with history of lump and pain on left side of the abdomen. On evaluation, he had bilateral giant adrenal myelolipomas, left being 22x15x12 cm and right being 11x8.2x7cms with hypertension. Laboratory examination of adrenal function revealed normal results. Bilateral adrenalectomy wa...