Management of an incidentally found large adrenal myelolipoma: a case report (original) (raw)

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 of a 60-year-old male with giant adrenal myelolipoma

International Surgery Journal

Adrenal myelolipoma is a 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 with varying amounts of hematopoietic components. In the past, these tumors were discovered at autopsy, with an incidence ranging from 0.08% to 0.4%. Today, with the widespread use of radiological studies such as ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), the incidental detection of myelolipoma has become more common, constituting up to 10-15% of incidental adrenal masses. The patient was hospitalized for a 3-month history of discomfort in the right flank, swelling over the right hypochondriac area, constipation, retrosternal burning sensation, and early satiety. His vitals were stable but per abdominal examination revealed a mass in the right hypochondrium. B-mode ultrasound screening revealed an adrenal tumor. A hematological examination r...

Incidental Detection of Adrenal Myelolipoma: A Case Report and Review of Literature

Case Reports in Urology, 2013

Introduction. Adrenal myelolipoma is a rare tumor that is benign in nature, usually asymptomatic, unilateral, and nonsecreting. It is composed of variable mixture of mature adipose tissue and hematopoietic elements and develops within the adrenal gland. With the widespread use of cross-sectional imaging modalities such as ultrasonography and computed tomography, the incidental detection of these tumors is increasing in frequency.Case Presentation. We report a case of adrenal myelolipoma in a 63-year-old Kashmiri male, who presented with pain in the right upper abdomen. Physical examination was unremarkable. Ultrasound abdomen showed the presence of a hyperechoic mass in the right suprarenal region with undefined margins. Contrast-enhanced computed tomography (CECT) scan of abdomen revealed a well-defined, round lesion in the right suprarenal region with heterogeneous attenuation suggesting the possibility of myelolipoma. The patient was subjected to right adrenalectomy and his posto...

Very rare giant adrenal myelolipoma: a tumor mimic

International Surgery Journal, 2020

Adrenal myelolipoma is a very rare benign neoplasm usually unilateral, and nonsecreting, occurring in the adrenal gland which consist of fatty tissues and hematopoietic elements. Some cases of this type may cause symptoms like chronic abdominal pain however usually these tumors are small and asymptomatic. Surgery is the modality of treatment where there are severe symptoms with life threatening progression with size of tumor reaching more than 6 cm. Here we report an unusual case of a 59-year-old male with history of chronic abdominal pain from a growing right-sided large adrenal mass. With all possible hematological, histo-pathological as well as imaging investigations warranted a high suspicion for tumor mass, hence decided for surgically excision, which was both diagnostic as well as curative. The histopathological study of the excised mass confirmed the initial diagnosis of adrenal myelolipoma. Surgery is the diagnostic and curative modality of treatment for adrenal myelolipoma ...

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...

Clinicopathological Characteristics of Four Cases of Adrenal Myelolipomas: A Rare Surgical Entity

World Journal of Oncology, 2012

Myelolipomas are unusual benign tumors or tumor-like lesions, composed of hematopoietic cells and mature adipose tissue. They usually are asymptomatic and behave as non-functioning, unilateral, small adrenal tumors often found incidentally on imaging studies. We report the clinicopathological characteristics of four cases of adrenal myelolipomas treated in our hospital, worth to mention because of their rarity and their significant size. Myelolipomas were first described by Gierke in 1905, and the term myelolipoma was coined by Oberling in 1929. The adrenal gland is the most common site, but myelolipomas are also rarely present in extra-adrenal sites, including the pelvis, mediastinum, retroperitoneum, and paravertebral region, as an isolated soft tissue mass. These tumors account for 2.6% of the primary adrenal masses with equal sex distribution and in our reviewed material of a decade they constitute about 5% in a series of surgically treated adrenals for various neoplastic processes of the adrenals. Although usually small in size, in our series a remarkable large size of the tumors examined was observed, ranging from 7-15 cm. Adrenal myelolipoma is often an "incidentaloma", since its diagnosis is frequently based on autoptic findings or made during surgical interventions and imaging procedures performed for other purposes, as happened in our cases.

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.

Adrenal myelolipoma: from tumorigenesis to management

Pan African Medical Journal, 2019

Adrenal myelolipoma (MLS) is a rare, benign and non-functional neoplasm, composed of adipose tissue and myeloid. We report a rare case of adrenal myelolipoma of a 20-year-old female revealed with chronic abdominal pain. Computed tomography (CT) scan of the abdomen guided diagnosis and surgical resection was performed given symptomatic and bulky mass. Histological examination confirmed the diagnosis. At 18 months after the surgery, the patient had no evidence of recurrence. The diagnosis of MLS is radiological. Therapeutic abstention is the rule for a small, asymptomatic tumor. The surgical removal is indicated when it is bulky (exceeds 7cm), symptomatic or hormonal activity.

Adrenal myelolipoma: Case report with a review of the literature

Australasian Radiology, 1996

A 40 year old woman who was pre-operatively diagnosed as possibly having adrenal myelolipoma is reported. Adrenal myelolipomas are rare, non-functional benign tumours comprising varying amounts of fat and haematopoietic elements. Albeit possibly coincidental, there is a frequent association with obesity, hypertension, and/or diabetes mellitus. A growing number of patients are being diagnosed during ultrasonographic or computerized tomographic scanning for unrelated problems.

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.