Case Of Adrenal Myelolipoma Research Articles

A case of adrenal myelolipoma: A rare encounter requiring specific approach in diagnosis and management

A case of adrenal myelolipoma: A rare encounter requiring specific approach in diagnosis and management

Adrenal Myelolipoma with Haemorrhage

Myelolipomas are a rare benign variant of adipose tissue tumors with additional hematopoietic elements. Generally, these tumors were discovered accidentally on autopsy with a low incidence. Adrenal gland is the most common site for myelolipoma. We report a case of adrenal myelolipoma (7 cm) in female in her 4th decade who presented with pain right side abdomen which can be confused with other adrenal malignancy.

A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

Adrenal myelolipoma (AM) is a benign tumor composed of mature fat cells and hemopoietic elements. Most AMs are incidental findings on imaging and clinically asymptomatic. The purpose of this case report is to describe a rare case of AM and explore its clinical manifestations, imaging features, and treatment. In this study, we report a case of a rapidly growing right AM in a patient with uncontrolled hemoglobin sickle cell disease. A 38-year-old male presented to our institution's endocrine surgery clinic for evaluation of an enlarging right adrenal mass. This mass was incidentally found during an abdominal ultrasound performed for transaminitis and thrombocytopenia. Patient was asymptomatic without any abdominal discomfort, back pain, nausea, or vomiting. Patient was lost to follow up until 2018. Follow-up computed tomography scan in 2018 showed the right adrenal mass measuring 12.3 cm in greatest dimension with significant macroscopic fat. Given the imaging features, AM was the presumed diagnosis. However, with a medical history of uncontrolled sickle cell disease, extra-medullary hematopoiesis and rapidly growing liposarcoma could not be ruled out. Surgical excision was performed due to size and significant tumor growth. Diagnosis was confirmed with histopathology and revealed myelolipoma. Image characteristics can be helpful in diagnosis of AM; however, the appearance of this lesion on computed tomography can be similar to other adrenal gland pathologies such as liposarcoma and mass-forming extramedullary hematopoiesis. Percutaneous needle biopsy may be indicated if the diagnosis remains unclear.

Retroperitoneal teratoma simulating giant adrenal myelolipoma: a diagnostic puzzle

Teratoma is a germ-cell tumour that is common in para-axial regions. Retroperitoneal teratoma is rare and comprise only about 1% of all teratomas. We present a 21-year-old female who presented...

Intra-abdominal bleeding with hemorrhagic shock: a case of adrenal myelolipoma and review of literature

Adrenal myelolipoma is an uncommon, benign, and hormonally non-functioning tumor that is composed of mature adipose tissue and normal hematopoietic tissue. Most cases to date are asymptomatic or have epigastric pain. Acute hemorrhage is the most dramatic manifestation of adrenal myelolipoma; though, it is a rare entity. Hemorrhagic shock due to adrenal myelolipoma, to our knowledge, was much less mentioned so far. Persistent bleeding and uncontrollable hypotension are considered to be absolute indications for immediate surgical operation. Herein we presented a 32-year-old male patient with initial symptoms of nausea, vomiting, and epigastric pain progressing to altered consciousness and hypotension during ER course. Hemorrhagic shock due to a giant adrenal myelolipoma, R’t was diagnosed. Emergent exploratory laparotomy was executed, and en bloc excision of tumor was done. Adrenal myelolipoma might be diagnosed as a adjunction to other main causes of illness; furthermore, adrenal myelolipoma could be asymptomatic in lifetime. In our case, however, manifesting as hemorrhage shock was challenging to diagnose step by step; instead, maintaining vital organs perfusion and identifying bleeding sources were to be done. Management of myelolipoma should be done on a case-to-case basis.

健診の腹部超音波検査により発見し腹腔鏡下摘出術がなされた副腎骨髄脂肪腫の一例

症例は41歳男性、2014年2月に当院健診センターを受診し、初めて受けた健診による腹部超音波検査にて当初肝右葉と思われた領域に境界明瞭で輪郭が平滑で、内部エコーが均一な高エコー像を認めた。当初、肝血管腫などを疑った。精密検査による造影CT検査、MRI、腹部血管造影の再検査、内分泌血液検査および腹部超音波の再検査にて、副腎骨髄脂肪腫と診断した。本人の希望にて経過観察となって、1年後に再び当院健診で行った腹部超音波検査にて腫瘤像が増大したため腹腔鏡下摘出手術を行った。病理検査にて副腎骨髄脂肪腫と確定診断された。

Giant myelolipoma of left adrenal gland simulating a retroperitoneal sarcoma

Adrenal myelolipoma is a rare benign tumor composed of an admixture of adipose and hematopoietic tissue. Most tumors are asymptomatic, small in size, right-sided, and usually detected incidentally. Though they are often smaller than four cm in diameter, they can reach larger sizes. Giant adrenal myelolipomas are extremely rare tumors having only about 10 reported cases in the literature. Presently, a case is being reported in a 59-year-old lady who presented with abdominal distention and dragging sensation in the upper left abdomen. Computed tomography of the abdomen revealed a retroperitoneal tumor which was suspected to be a retroperitoneal sarcoma. Other fat containing retroperitoneal tumors such as a lipoma, myelolipoma and teratoma were also considered as possibilities. All hormonal studies related to adrenal gland were within normal limits. The patient underwent surgical resection of the tumor. The resected mass was 23 cm × 16 cm ×9 cm in size and weighed 3.3 kg. Histopathological examination revealed the tumor to be an adrenal myelolipoma. This present case of adrenal myelolipoma is unusual in view of its left-sided location and its large size which clinically and radiologically simulated a retroperitoneal sarcoma.

Adrenal myelolipoma: A rare benign neoplasm

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. One case of adrenal myelolipoma is presented here which was hormonally inactive and discovered incidentally during ultrasound examination.

Adrenal myelolipoma associated with hyperandrogenemia

Adrenal myelolipoma associated with hyperandrogenemia is extremely rare. We present such a case here. The patient was a 34-year-old Chinese woman with a history of growth retardation, virilization and lumbago. Adrenal imaging showed a circular soft tissue mass in the right adrenal gland. Endocrine examinations showed increased levels of plasma testosterone and dehydroepiandrosterone sulfate, significantly lower levels of follicle-stimulating hormone and luteinizing hormone, with other biochemical parameters being basically normal. After a histopathological study confirming the mass to be an adrenal myelolipoma, the patient was managed with a right adrenalectomy and then recovered. A search of the English and Japanese language literature suggests this is the first detailed and documented case of adrenal myelolipoma associated with hyperandrogenemia.

Adrenal Myelolipoma - An Enigma

Adrenal myelolipomas are rare neoplasms. They are benign in nature comprising mainly of adipose and myeloid tissues. Majority of these adrenal gland tumors are hormonally inactive. In view of their rarity, they are usually detected incidentally or misdiagnosed. Misdiagnosis is quite common and can lead to difficulty in management. We wish to report a case of adrenal myelolipoma that was misdiagnosed which fortunately did not result in a major issue. With the availability of advanced imaging techniques and minimally invasive procedures, these situations can easily be avoided. The main reason for highlighting this patient is to create awareness among both the surgeons and the radiologists.

Mielolipoma de la glándula suprarrenal: Informe de un caso y revisión de la literatura

We report one case of adrenal myelolipoma in a female patient presenting with right lumbar pain over six months.Diagnostic work included ultrasound, intravenous urography (IVU) and CT scan.The patient underwent right adenomectomy with the working diagnosis of adrenal myelolipoma. We describe the pathology report.Myelolipoma may present hematopoietic, fat and bone components. It continues being an incidental finding. Ultrasound and CT scan are effective diagnostic tests. Asymptomatic small tumors, smaller than 4 cm, may be monitored with watchful waiting. Symptomatic tumors greater than 4 cm should be extirpated because of the risk of spontaneous rupture with retroperitoneal bleeding. Bilateral adrenalectomy for big tumors implies medical replacement with hydrocortisone.

Adrenal myelolipoma in a child

A case of adrenal myelolipoma is reported in a 14-year-old girl. Abdominal ultrasound examination revealed a left-sided ovarian cyst 13 cm in diameter and an 8 x 8-cm hyperechoic heterogenous solid mass localized in the right adrenal gland. The ovarian cyst and adrenal mass were removed surgically. Histological examination of the adrenal mass revealed a proliferation of mature adipose tissue with bone marrow-like hematopoietic elements. The ovarian cyst was a simple serous cyst.

Adrenal myelolipoma with translocation (3;21)(q25;p11)

Adrenal myelolipoma (ML) is a rare, benign, nonfunctioning tumor-like lesion composed of mature adipose tissue interspersed with bone marrow-like hematopoietic elements in various proportions. It occurs usually in adults and is frequently asymptomatic in about half of cases. The histogenesis of adrenal ML is not clear and this lesion has been found to be associated with endocrine disorders, other adrenal dysfunction and tumors, and hyperstimulation with adrenocorticotropic hormone. Specific chromosomal abnormalities, however, have not been observed in such cases. Herein, we report a typical case of adrenal ML found incidentally in a 26-year-old man. Conventional cytogenetic techniques demonstrated balanced translocation between bands 3q25 and 21p11 in 9 of 20 metaphases analyzed in cultured tumor cells. To the best of our knowledge, this is the first reported case of adrenal ML showing chromosomal abnormality. This finding would indicate that adrenal ML is a bona fide neoplasm and the possibility of derivation from misplaced hematopoietic cells may be alternatively taken into consideration in view of the similar genetic changes in hematopolietic neoplasms.

Adrenal Myelolipoma Associated with Hereditary Spherocytosis

Myelolipomas are benign tumors composed of mature fat and bone marrow elements. We report a case of adrenal myelolipoma associated with hereditary spherocytosis which was treated with splenectomy seventeen years ago. The hematopoietic stimulus of the hereditary spherocytosis might have been associated with the development of adrenal myelolipoma in the present case.

Hemorrhagic myelolipoma of adrenal gland after blunt trauma

A case of adrenal myelolipoma is reported in a patient in whom symptoms of hematuria and flank pain developed after the patient had sustained blunt trauma. Adrenal myelolipomas are usually found incidentally at autopsy. However, the symptomatic presentation of this patient was probably caused by traumatic intratumor hemorrhage. The etiology and pathogenesis of these tumors are discussed in relation to their occasional symptomatic presentation and to their differential diagnosis.

Adrenal Myelolipoma Simulating Virilizing Adrenal Tumor

We describe a case of adrenal myelolipoma that simulated clinically and biochemically a virilizing adrenal tumor. The tumor was removed surgically. The preoperative diagnosis of adrenal myelolipoma can be made by the characteristic appearance on ultrasonography, computerized tomography and in equivocal cases by guided needle biopsy.