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Abstract
We herein present a surgically treated case of huge adrenal myelolipoma. A 62-year-old woman presented to our surgical outpatient clinic with a retroperitoneal tumor. A clinical examination revealed an elastic soft, smooth-surfaced, painless, child-head-sized tumor with poor mobility, which was located in the left upper abdomen. Computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen revealed an uneven tumor surrounding the stomach, spleen, pancreas, and left kidney, which was 20 × 18 × 10 cm in size. The retroperitoneal tumor was resected. The tumor was attached to the surrounding organs, including the pancreas, spleen, and left kidney, but had not directly invaded these organs. The tumor was yellow and elastic soft and covered with a thin film. The origin of the tumor was suggested to be the left adrenal gland. The weight of the excised tumor was 1500 g. The histopathological diagnosis was adrenal myelolipoma. The patient had an uneventful recovery and was discharged from the hospital on the thirteenth day after the operation. She has been followed up in our outpatient clinic.
Highlights
Adrenal myelolipoma (AML) is a relatively rare benign tumor composed of mature adipose tissues and a variable amount of hematopoietic elements
The largest AML in a patient without endocrine disorder was described by Akamatsu et al [6], while the largest AML in a patient with congenital adrenal hyperplasia (CAH) was described by Boudreaux et al [7]
The most widely accepted theory is that myelolipomas arise due to metaplasia of the reticuloendothelial cells of the blood capillaries in the adrenal gland in response to stimuli such as chronic stress, infection, necrosis, or inflammation [11, 12]
Summary
Adrenal myelolipoma (AML) is a relatively rare benign tumor composed of mature adipose tissues and a variable amount of hematopoietic elements. The incidence of AML is reported to be 0.08–0.4% at autopsy [1]. AMLs are nonfunctional tumors that are usually asymptomatic; they have been known to coexist with other endocrine disorders, such as Cushing’s syndrome, congenital adrenal hyperplasia (CAH), Conn’s syndrome, and pheochromocytoma [2,3,4]. AMLs have been reported in patients with CAH with increasing frequency. We report a relatively rare case of a giant AML of g in weight in a patient without endocrine disorder and discuss our analysis of the literature
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