Adrenal myelolipoma: from tumorigenesis to management

Mhammedi, Wassim Alaoui; Ouslim, Hicham; Ouraghi, Abdelghani; Irzi, Mohammed; Elhoumaidi, Amine; Chennoufi, Mehdi; Mokhtari, Mohammed; Elmouden, Anouar; Barki, Ali

doi:10.11604/pamj.2019.34.180.20891

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…The laparoscopic operation was once considered contraindicated for adrenal tumors exceeding 5-6 cm (26). However, the laparoscopic approach is being increasingly used and extended for larger-size adrenal tumors, and we found 18 articles published reported 23 cases in recent 10 years (3,4,17,25,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). Table 1 provides further details of these reports.…”

Section: Discussionmentioning

confidence: 99%

Case report: Adrenal myelolipoma resected by laparoscopic surgery

Feng

Chen

et al. 2022

Front. Oncol.

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IntroductionAdrenal myelolipomas are benign tumors composed mainly of lipomatous elements with myeloid cells. With the development of medical imaging technology, the detection rate has gradually increased. We report a case of adrenal myelolipoma successfully excised through the laparoscope and reviewed existing literature in recent ten years to summarize the feasibility of the laparoscopic approach for this tumor.Case presentationHerein, we described a case of adrenal myelolipoma resected by laparoscope in a 63-year-old male patient. He did not have any other symptoms except the incidental finding of a left adrenal mass. An abdominal CT examination revealed a mixed-density lesion containing some amount of adipose tissue. In conjunction with the patient’s willingness, we performed a laparoscopic operation to remove the lump. The definite diagnosis was confirmed as an adrenal myelolipoma according to the pathology. The patient recovered well postoperatively and without signs of recurrence at a 5-month follow-up.ConclusionAdrenal myelolipoma is commonly benign, asymptomatic, and hormonal inactivity. A surgical strategy is suggested for high-complication-risk patients. The laparoscopic approach is safe and effective with an obvious advantage over open procedures.

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Section: Discussionmentioning

confidence: 99%

Case report: Adrenal myelolipoma resected by laparoscopic surgery

Feng

Chen

et al. 2022

Front. Oncol.

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“…In 1905, myelolipoma was first described by Gierke [ 3 ] who reported the histological findings of a mixed proportion of mature adipose tissues and hematopoietic elements. The most common site of occurrence is the adrenal gland, and this tumor accounts for 2–4% of all adrenal tumors [ 4 ]. Myelolipoma typically does not cause any tumor-related symptoms or endocrine disturbances and has been reported as a type of incidentaloma detected during CT for other diseases [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Myelolipoma mimicking osteosarcoma in the distal femur

Sakai

Aiba

Nakagawa

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Periosteal reactions indicate malignant bone tumors, including osteosarcoma; establishing an accurate diagnosis is key to determining the most appropriate treatment strategy. We describe a rare case of myelolipoma in the distal femur metaphysis with massive extraskeletal lesions and periosteal reactions. Case presentation A 25-year-old woman was referred to our hospital to treat a gradually expanding mass around her knee that grew to the size of a baby's head. She had a history of hydrocephalus caused by congenital cytomegalovirus infection and was bedridden for life. Radiography showed a prominent osteoblastic rim and osteolytic lesion with a moth-eaten appearance. Osteosarcoma was suspected due to excessive extraskeletal invasion and periosteal reactions. T1- and T2-weighted magnetic resonance images showed a high-signal-intensity homologous lesion. Biopsy specimens contained adipose and hematopoietic tissues. A myelolipoma was diagnosed. Due to her fragility, surgical intervention was suspended. Two years after diagnosis, the tumor size did not change. Clinical discussion Myelolipomas are benign tumors that typically arise from the adrenal gland and rarely develop in the extremities. This type of tumor typically does not cause any tumor-related symptoms or endocrine disturbances and has been reported as a type of incidentaloma. To effectively manage myelolipoma patients, differential diagnosis of tumors mimicking malignant bone tumors is important. Conclusion We successfully managed a destructive ectopic myelolipoma in the distal femoral metaphysis, with massive extraskeletal lesions and periosteal reactions. Clinicians should appropriately differentiate myelolipoma from tumors mimicking malignant bone tumors.

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“…Some may present with abdominal pain because of huge size or due to haemorrhage or necrosis within the tumour [30]. Myelolipomas is rarely manifested by spontaneous retroperitoneal haemorrhage, which remains the most serious complication with mortality of up to 80% [31]. Transcatheter embolization before surgical resection has been used successfully to achieve haemostasis in cases of ruptured myelolipomas leading to retroperitoneal haemorrhage [32].…”

Section: Discussionmentioning

confidence: 99%

Giant adrenal myelolipoma treated by laparoscopic excision: A case report and review of literature

Pogula¹,

Galeti²,

Thakare³

et al. 2021

ann urol oncol

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Adrenal myelolipoma is inevitably a benign neoplasm of the adrenal gland. It is the second most common primary adrenal incidentaloma after adrenocortical adenomas. Adrenal myelolipoma is a rare, benign and non-functional neoplasm, composed of mature adipose and hematopoietic tissue which closely resembles bone marrow. Most of these lesions are small, unilateral and asymptomatic, discovered incidentally at autopsy or on imaging studies performed for other reasons. We report a case of this rare tumour in a 46-year-old obese male who had presented with vague abdominal pain on the right side past 6 months without any other significant history. Ultrasound and subsequently CECT scan abdomen showed a large well-circumscribed mass arising from the right adrenal gland, measuring 11×10cm. Laparoscopic right adrenalectomy was performed.

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Adrenal myelolipoma: from tumorigenesis to management

Cited by 8 publications

References 12 publications

Case report: Adrenal myelolipoma resected by laparoscopic surgery

Case report: Adrenal myelolipoma resected by laparoscopic surgery

Myelolipoma mimicking osteosarcoma in the distal femur

Giant adrenal myelolipoma treated by laparoscopic excision: A case report and review of literature

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