Incidentally discovered adrenal mass: A study of two cases and review of literature

Abstract

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 (USG) and computed tomography (CT), the incidental detection of these tumors is increasing in frequency. We report two cases of adrenal myelolipoma in a 48-year-old female and a 47-year old male who presented with pain in the abdomen. Contrast-enhanced computed tomography scan of the abdomen revealed the possibility of myelolipoma. The patients were subjected to adrenalectomy and their postoperative course was uneventful. The histopathological evaluation of the mass confirmed the initial diagnosis of adrenal myelolipoma. Although mostly discovered as an “incidentaloma,” the diagnosis of adrenal myelolipoma requires thorough diagnostic study. Imaging techniques such as USG and CT scans as well as biochemical studies are useful for indicating the best treatment taking into account the size of the mass and possible hormone production. Surgical resection is advocated through extraperitoneal approach as it minimizes postoperative complications and leads to quicker recovery.