Adrenocortical adenoma containing a fat component: CT and MR image evaluation

Sato, Noriko; Watanabe, Yuji; Saga, Tsutomu; Mitsudo, Kazuaki; Dohke, Masako; Minami, Kazuhiko

doi:10.1007/bf01213281

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…3 However, it is widely accepted that demonstration of fat within a solid adrenal mass on a CT scan strongly suggests the diagnosis of myelolipoma and can rule out adrenocortical adenoma. 4 Our patient had an adrenocortical adenoma that was an incidental finding during magnetic resonance (MR) imaging. This type of tumor is uncommon, especially because this tumor contained a fat component and extensive areas of fibrosis.…”

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confidence: 91%

“…The distinction between benign and malignant adrenocortical tumors can often be difficult, and the diagnosis is usually made after consideration of a combination of clinical, gross and microscopic features 3 . However, it is widely accepted that demonstration of fat within a solid adrenal mass on a CT scan strongly suggests the diagnosis of myelolipoma and can rule out adrenocortical adenoma 4 . Our patient had an adrenocortical adenoma that was an incidental finding during magnetic resonance (MR) imaging.…”

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confidence: 93%

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Non‐functional adrenocortical adenoma with extensive degeneration

Masugi

Kameyama

Aiba

et al. 2003

Pathology International

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We report a case of non-functional adrenocortical adenoma of 5.5 x 5.5 x 3.2 cm in size that had an unusual histopathological appearance in two respects. First, the tumor contained small adipose foci with osteogenesis and was suspected of being a myelolipoma based on its appearance on computerized tomography (CT) and magnetic resonance imaging. However, pathologically, the fat element was seen focally and was not accompanied by hematopoietic cells, and the diagnosis of myelolipoma was abandoned. Second, the tumor was suspected of being an adrenal carcinoma based on its appearance on CT scans and showed extensive degeneration: fibrosis, hemorrhage, loss of parenchyma and moderate atypism of the tumor cells. However, as the architecture of the tumor cells was non-diffuse and there were no necrotic foci or mitoses, and vascular or capsular invasion were not present, the tumor was concluded to be an adrenocortical adenoma rather than a carcinoma. We diagnosed the tumor as a non-functional adrenocortical adenoma with extensive degeneration as the extensive areas of fibrosis were particularly remarkable. Furthermore, the extensive areas of degeneration might have been caused not only by an ischemic effect but also by low hormone levels.

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confidence: 91%

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confidence: 93%

Non‐functional adrenocortical adenoma with extensive degeneration

Masugi

Kameyama

Aiba

et al. 2003

Pathology International

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“…Seven adrenal cortical adenomas with extensive area of adipose tissue have been described in the literature. They have been labelled as adrenal cortical adenoma with fat component (Sato et al 1995), adenoma with lipomatous metaplasia (Papotti et al 1996), adrenal cortical extensive fat cell metaplasia (Feldberg et al 1996) and lipoadenoma (Mylarappa et al 2014, Uriev et al 2014, Luo et al 2015. In addition, Montone and coworkers have reported 2 cases of adrenocortical neoplasm with uncertain malignant potential having separate areas of myelolipomatous and lipomatous metaplasia (Montone et al 2009).…”

Section: Adrenocortical Tumours With Fat Componentmentioning

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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“…Drawback remains in the case of ACC, pheochromocytoma, and clear cell renal cell cancer metastasis, which may also have macroscopic lipid content. [ 7 14 15 16 ]…”

Section: Introductionmentioning

confidence: 99%

“…[ 34 ] Isolated cases of macroscopic fat within the tumor mimicking myelolipoma have also been reported. [ 14 15 16 ] However, such imaging features are exceptions and their presence in large and heterogeneous adrenal masses should not be mislabeled as a benign adenoma or myelolipoma.…”

Section: Introductionmentioning

confidence: 99%

Adrenal imaging (Part 1): Imaging techniques and primary cortical lesions

Das

Dhamija

Kumar

et al. 2015

Indian J Endocr Metab

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Adrenal glands can be affected by a variety of lesions. Adrenal lesions can either be primary, of adrenal origin, or secondary to other pathologies. Primary adrenal lesions can further be either of cortical or medullary origin. Functioning adrenal lesions can also give clues to the histologic diagnosis and direct workup. Over the years, various imaging techniques have been developed that have increased diagnostic accuracy and helped in better characterization of adrenal lesions non-invasively. In the first part of the two part series, we review adrenal imaging techniques and adrenal cortical tumors such as adenomas, adrenocortical tumors, adrenal hyperplasia and oncocytomas.

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Adrenocortical adenoma containing a fat component: CT and MR image evaluation

Abstract: A case of adrenocortical adenoma containing small adipose foci is presented. A small amount of fat within the mass led to an erroneous preoperative diagnosis of myelolipoma. Adrenal adenoma should be included in the differential diagnosis of adrenal mass containing fat.

Cited by 14 publications

References 11 publications

Non‐functional adrenocortical adenoma with extensive degeneration

Non‐functional adrenocortical adenoma with extensive degeneration

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Adrenal imaging (Part 1): Imaging techniques and primary cortical lesions

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