Myelolipoma: a rare incidentally detected adrenal lesion
Keywords:
Adrenal myelolipomas, lipomatous tumours, benign, rare
Abstract
Adrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to frequent use of imaging studies. They are lipomatous tumours They are usually asymptomatic and sometimes associated with endocrinological dysfunction.We report a case of middle aged gentleman, with accidentally detected adrenal mass and no hormonal disturbances. The patient was evaluated initially for fever. Laboratory investigations revealed evidence of urinary tract infection. Ultrasound abdomen showed a hyperechoeic mass in suprarenal region with a hypoechoeic component. The patient was managed conservatively and discharged after a few days. On further work up, MRI showed a well defined suprarenal mass with hyperintensity, possibly adrenal myelolipoma. The tumour was removed laparoscopically and histopathology revealed features of myelolipoma. The patient was discahrged after an uneventful postoperative period.Adrenal myelolipomas are rare, benign tumours of adrenal gland diagnosed incidentally. Careful evaluation is important including imaging studies and endocrinological testing. Larger or symptomatic tumours can be excised surgically. Laparoscopic resection is a safe procedure in tumours considered for surgery, with favourable patient outcome.DOI:10.21276/APALM.1447References
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12. Lee JJ, Dickson BC, Sreeharsha B, Gladdy RA, Thipphavong S. Presacral myelolipoma : Diagnosis on imaging with pathologic and clinical correlation. AJR Am J Roentgenol. 2016 Sep;207(3):470-81.
13. Yamashita S, Ito K, Furushima K, Fulushima J, Kameyama S, Harihara Y. Laparoscopic versus open adrenalectomy for adrenal myelolipoma. Ann Med Surg (Lond). 2014Apr 16;3(2):34-8.
14. Yalagachin GH, Bhat BK. Adrenal incidentaloma does it require surgical treatment? Case report and review of literature. Int J Case Rep. 2013;4(2):192-4.
2. Gershuni VM, Bittner JG Ivth, Moley JF, Brunt LM. Adrenal Myelolipoma: Operative Indications and Outcomes. J Laparoendosc Adv Surg Tech A. 2014 Jan;24(1);8-12.
3. Lam KY, Lo CY. Adrenal lipomatous tumours: a 30 year clinicopathological experience at a single institution . J Clin Pathol 2001;54(9):707–12.
4. Song JH, Chaudhary FS, Mayo-Smith WW. The incidental adrenal mass on CT : prevalence of adrenal disease in 1049 adrenal masses in patients with no known malignancy. Am J Roentgenol. 2008 May;190(5): 1163-8.
5. Nabi J, Rafiq D, Authoy FN, Sofi GN. Incidental detection of adrenal myelolipoma : A case report and review of literature. Case Rep Urol. 2013. Epub 2013 Feb 20.
6. Su HC, Huang X, Zhou WL, Dai J, Huang BX, Cao WL, Sun FK. Pathologic analysis, diagnosis and treatment of adrenal myelolipoma. Can Urol Assoc J. 2014 Sep; 8 : 9-10.
7. Sandoval MA, Anel-Quimpo J. A giant myelolipoma discovered as an adrenal incidentaloma: radiological, endocrine and pathological evaluation. BMJ case Rep Dec 20;2010.
8. Ilias I, Sahdev A, Reznek RH, Grossman AB, Pacak K. The optimal imaging of adrenal tumours: a comparison of different methods. Endocr Relat Cancer. 2007 Sep;14(3):587-99.
9. Shi Q, Pan S, Bao Y, Fan H, Diao Y. Primary mediastinal myelolipoma: a case report and literature review. J Thorac Dis. 2017 Mar;9(3):E219-E225.
10. Shen C, Zhou K, Lai Y, Fan J, Liu L, Che G. Review of primary extra-adrenal myelolipoma of the thorax. J Surg Res. 2017 Jan;207:131-137.
11. Ghaouti M, Znati K, Jahid A, Zouaidia F, Bernoussi Z, Mahassini N. Renal myelolipoma: a rare extra-adrenal tumour in a rare site: a case report and review of the literature. J Med Case Rep. 2013 Apr 4;7:92.
12. Lee JJ, Dickson BC, Sreeharsha B, Gladdy RA, Thipphavong S. Presacral myelolipoma : Diagnosis on imaging with pathologic and clinical correlation. AJR Am J Roentgenol. 2016 Sep;207(3):470-81.
13. Yamashita S, Ito K, Furushima K, Fulushima J, Kameyama S, Harihara Y. Laparoscopic versus open adrenalectomy for adrenal myelolipoma. Ann Med Surg (Lond). 2014Apr 16;3(2):34-8.
14. Yalagachin GH, Bhat BK. Adrenal incidentaloma does it require surgical treatment? Case report and review of literature. Int J Case Rep. 2013;4(2):192-4.
Published
2017-10-27
Issue
Section
Case Report
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