Adrenal myelolipoma: A 10‐year single‐center experience and literature review

Hsu, Sz-Wen; Shu, Kenneth; Lee, Wei-Ching; Cheng, Yongjie; Chiang, Po‐Hui

doi:10.1016/j.kjms.2012.02.005

Cited by 21 publications

(28 citation statements)

References 33 publications

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“…It is most often noted in patients between fifth and seventh decades of life with an average age at presentation in the sixth decade of life. There is a wide age range at presentation from 16 months to 84 years (Lam & Lo 2001, Hsu et al 2012 Barman et al 2014). Also, it is twice more frequently seen in right adrenal gland as compared to the left (Table 1).…”

Section: Myelolipomamentioning

confidence: 99%

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lam¹

2017

Endocrine-Related Cancer

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Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO) classification of tumours of endocrine organs, adrenal myelolipoma is the only entity amongst the group of tumours being described. In the literature, other more recently documented adrenal lipomatous tumours included 24 lipomas, 32 teratomas and 16 angiomyolipomas. Rare fatty tumours of the adrenal gland comprised liposarcoma, hibernoma, adrenocortical tumours with fat component and rare adrenal tumours with fat component. Myelolipoma comprises approximately 3% of primary adrenal tumour. It is noted more commonly in females and in the right adrenal gland. Approximately 40 bilateral myelolipomas were reported. The tumour is most frequently recorded in patients between fifth and seventh decades of life. Adrenal lipomas are often seen in males and in the right adrenal gland. They were commonly noted in patients in the sixth decade of life. The diagnosis could only be possible on examination of the surgically removed specimen. Adrenal teratomas were more common in females and with a bimodal age distribution. Slightly over 60% of the patients with adrenal teratoma are symptomatic. Adrenal angiomyolipomas were often symptomatic, more common in females and in the fifth decades of life. To conclude, adrenal lipomatous tumour is uncommon. They are often benign and non-functional. It is important to recognize the features of this group of lipomatous tumours in the adrenal gland as they are being detected on increasing incidence as a result of the wide-spread use of modern imaging modalities.

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Section: Myelolipomamentioning

confidence: 99%

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lam¹

2017

Endocrine-Related Cancer

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“…Their size is, in general, under 4 cm, but they can also reach greater size (the greatest myelolipoma described in the literature was of 31x24.5x11.5 cm and weighted 6 kg) (5,6,10,11). Symptomatic forms usually present with unregulated pain in the epigastrium and flanks (right or left depending of the localization of the tumor), abdominal discomfort, rarely hematuria or signs of hemorrhagic shock caused by spontaneous rupture of the tumor, with retroperitoneal bleeding (2,3,5,7,9,12,13,14).…”

Section: Introductionmentioning

confidence: 99%

Anterior Transabdominal Laparoscopic Adrenalectomy, without Ligatures, for a Symptomatic Right Adrenal Myelolipoma with Intratumoral Hemorrhage

Molnar¹,

Lata²,

Pisica³

et al. 2017

chr

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“…When the diagnosis of myelolipoma is considered, it should be differentiated from other fat containing retroperitoneal tumors including retroperitoneal lipomas, retroperitoneal liposarcoma, extra-renal angiomyolipoma, extramedullary hematopoietic 'tumors', retroperitoneal leiomyosarcoma, primary or metastatic adrenal malignancy and teratomas [9,33,34].…”

Section: Discussionmentioning

confidence: 99%

“…From the reviewed papers, 17% cases whose tumor size was greater than 6 cm experienced spontaneous rupture. Therefore, elective surgery can prevent more severe symptom presentation and life-threatening progression and can allow accurate diagnosis in patients with tumors larger than 6 cm [33]. Castillo et al advocated laparoscopic adrenalectomies for myelolipoma.…”

Section: Discussionmentioning

confidence: 99%

Myelolipoma: A Rare Adrenal Incidentaloma

Tiwari¹,

Halder²

2015

Surgery

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Case ReportOpen Access IntroductionMyelolipomas are rare, benign tumors composed of mature adipose tissue and hematopoietic elements (myeloid and erythroid cells) [1]. We describe a case of dual pathology where adrenal incidentaloma was successfully treated. Case ReportA 40-year-old lady was referred to surgical outpatient clinic with an ultrasonologically detected adrenal mass, while being investigated for menorrhagia with a large pelvic mass. She did not have any symptoms related to the adrenal mass and was normotensive. Further biochemical investigations directed to adrenal pathology revealed a normal urinary VMA level, serum electrolytes and cortisol levels. The initial ultrasound scan suggested a well-defined, hyperechoic SOL in the left suprarenal region (94 x 80 mm) suggestive of a lipomatous tumour, along with a large intrauterine fibroid (119 x 96 mm). Subsequently, CECT of the abdomen revealed a large, well defined, mildly & heterogeneously enhancing mass lesion showing attenuation value of fat, involving left adrenal gland, suggestive of myolipoma (Figures 1 and 2). The right suprarenal was normal. In view of the large size of the uterine tumour and the fact that menorrhagia was under control, she underwent left adrenalectomy only in the first sitting, through a modified chevron incision. Macroscopical cut section of the specimen showed homogenous yellow surface with reddish streaking. Histopathology of the specimen revealed features of myelolipoma. She had an uneventful recovery and doing well now at six months follow up. Discussion and ConclusionEdgar von Gierke first described this lesion in the adrenal in 1905 but it was named, "myelolipoma", by Charles Oberling [2,3]. The adrenal gland is the most common site, but myelolipomas also (rarely) occur in extra-adrenal sites (14% of myelolipomas are extraadrenal [4]) including the pelvis, mediastinum, retroperitoneum, and paravertebral region, as an isolated soft tissue mass [5].It is usually hormonally inactive, and found in 0.08 to 0.2% of autopsy series [6,7] but comprise up to 15% of adrenal incidentalomas with the increasing use of noninvasive imaging [8] and account for 2.6% of all primary adrenal tumours [9]. Myelolipomas, affect both sexes equally and usually occur during fifth and seventh decades of life [10]. Adrenal myelolipomas are in the majority of cases unilateral. However, they can also be bilateral [11]. Adrenal myelolipomas may be found coincidentally with other lesions in the adrenal glands, such as adenomas and less commonly with pheochromocytoma or metastases. These cases are described as "collision tumours" [12].Adrenal myelolipomas vary in size, from several millimetres to more than 30 cm, and usually in the range of 2-10 cm in diameter [1,13]. The term giant myelolipoma is preferred when the size exceeds 8 cm [14], as seen in our case. AbstractBackground: Myelolipoma is a rarely encountered, adrenal incidentaloma diagnosed on the basis of its radiological features.Aim: To describe a rare presentation with dual pathology.Case p...

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Adrenal myelolipoma: A 10‐year single‐center experience and literature review

Cited by 21 publications

References 33 publications

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Anterior Transabdominal Laparoscopic Adrenalectomy, without Ligatures, for a Symptomatic Right Adrenal Myelolipoma with Intratumoral Hemorrhage

Myelolipoma: A Rare Adrenal Incidentaloma

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