Adrenal myelolipoma: report of a case and review of literature
ABSTRACT Adrenal myelolipoma is a rare benign tumor composed of mature lipomatous and hemopoietic tissue. Although it is often discovered as an incidental finding on imaging of the abdomen for some other reason or at autopsy, adrenal myelolipoma has been reported to present with symptoms such as flank pain resulting from tumor bulk, necrosis, or spontaneous retroperitoneal hemorrhage. Myelolipomas are hormonally inactive but have also been reported to coexist with other hormonally active tumors of the adrenal gland. They are usually unilateral but may be bilateral and may also develop in extraadrenal sites like the retroperitoneum, thorax, and pelvis. We report a patient with symptomatic adrenal myelolipoma diagnosed on computed tomography scan and confirmed on computed tomography-guided biopsy. The patient underwent surgical resection for symptomatic relief. We also review the literature to evaluate the presentation and optimal management of this rare adrenal tumor that is not encountered by most general surgeons and therefore not well known to most surgeons.
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- "Although many of these features are quite useful in distinguishing benign adrenal adenomas from adrenocortical carcinomas (particularly lesion size and washout), they have not been established as adequate markers for the distinction between adrenocortical carcinomas and other benign adrenal lesions such as myelolipoma . Myelolipomas are benign tumors usually arising from the adrenal gland that contain a combination of hematopoietic tissue and mature adipose tissue  . "
ABSTRACT: The presence of macroscopic fat in an adrenal mass has classically been associated with myelolipoma. Adrenocortical carcinoma is typically an aggressive malignancy with a poor prognosis. The presence of macroscopic fat is not a characteristic finding in adrenocortical carcinoma or other adrenal malignancies. We report a case of a newly discovered large adrenal mass containing multiple areas of macroscopic fat, which was pathologically proven to represent an adrenocortical carcinoma.Cancer Imaging 11/2010; 10(1):198-200. DOI:10.1102/1470-7330.2010.0029 · 1.29 Impact Factor
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ABSTRACT: Adrenal glands are common sites of diseases. With dramatically increased use of computed tomography (CT) and magnetic resonance (MR) imaging, more and more uncommon adrenal masses have been detected incidentally at abdominal examinations performed for other purposes. In this article, uncommon adrenal masses are classified as cystic masses (endothelial cysts, epithelial cysts, parasitic cysts, and pseudocysts), solid masses (ganglioneuroma, ganglioneuroblastoma, extramedullary plasmacytoma (EMP), neurilemmoma, and lymphoma), fat-containing masses (myelolipoma, teratoma), and infectious masses (tuberculoma), and the imaging features of these uncommon masses are demonstrated. Although most of these lesions do not have specific imaging features, some fat-containing masses and cystic lesions present with characteristic appearances, such as myelolipoma, teratoma, and hydatid. Combination with histopathologic characteristic of these uncommon masses of adrenal gland, radiological features of these lesions on CT and MR imaging can be accurately understood with more confidences. Moreover, CT and MRI are highly accurate in localization of uncommon adrenal masses, and useful to guide surgical treatments.European Journal of Radiology 07/2007; 62(3):359-70. DOI:10.1016/j.ejrad.2006.12.011 · 2.16 Impact Factor
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ABSTRACT: The lipomatous tumors of the adrenals are hormonally inactive lesions, often of a benign nature, such as myelolipomas, lipomas, angiomyolipomas, or mature teratomas, and are rarely malignant, such as liposarcomas. The importance of recognizing their characteristic radiological images, which would lead to their correct treatment, is fundamental since there has been an increase in the demonstration of this lesion, often detected incidentally. The various imaging procedures, although not allowing to formulate a histological diagnosis, nonetheless permit to determine the volume of the tumoral mass and their evolution. These two factors are of significant importance in the planning of the correct surgical procedure, while a third important factor is the proper evaluation of the symptoms presented by the patient. Regarding the treatment, on the basis of our own experience, which agrees with that of other authors, the surgical removal of any lesion greater than 5 cm is mandatory.Clinical Imaging 09/2007; 31(5):335-9. DOI:10.1016/j.clinimag.2007.06.022 · 0.60 Impact Factor