Adrenal Myelolipoma: Report of a Case and Review of the 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.

Simultaneous adrenal and extra-adrenal myelolipoma – an uncommon incident: case report and review of the literature

“…Only about 50 cases of extra-adrenal myelolipomas were reported yet in the literature [ 3 ]. The occurrence of most extra-adrenal myelolipomas were noted in the presacral soft tissue, followed by the retroperitoneum, the pelvis the stomach and in the musclefascial as well as a few have been reported in the perirenal tissue [ 1 , 3 , 4 , 8 , 9 , 14 - 18 ]. The aetiology of myelolipomas in general is so far unknown, although derivation from bone marrow tissue is discussed [ 2 ].…”

Variants of Adrenal Myelolipomas and Rare Concomitant Diseases

“…Альманах клинической медицины 106 № 32'2014 ми состояниями, инфекциями, другими опухолями, хроническими воспалительными процессами, ожирением, сахарным диабетом, ожоговой болезнью, врожденной гиперплазией коры надпочечников и другими хроническими заболеваниями [5,6]. В 5-15% миелолипомы проявляются синдромом Иценко -Кушинга, синдромом Конна, адреногенитальным синдромом [7,8].…”

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“…DISCUSSION: Myelolipomas are well-circumscribed lesions that contain mature adipose tissue intermixed with hematopoietic tissue. The adrenal gland is the most common site but myelolipomas also occur rarely in extraadrenal locations such as presacral soft tissues, retroperitoneum, thorax and pelvis 3 . The exact aetiopathogenesis of these tumors is still obscure.…”

“…Occasional patient presents with abdominal pain secondary to haemorrhage, tumor necrosis, or mechanical compression from tumour bulk 6 . Although they are not hormonally active, there is very rarely an association with functional adrenal disorders such as Cushing syndrome, Conn syndrome and congenital adrenal hyperplasia 3 . Malignant degeneration of adrenal myelolipoma has not been reported so far.…”