Bilateral Giant Adrenal Myelolipoma and Polycystic Ovarian Disease

Abstract

We report a case of a nonfunctioning, synchronous, bilateral, very large adrenal myelolipoma in an obese woman. She had diabetes mellitus and oligomenorrhea due to polycystic ovarian disease, and for that, she was taking progesterone medication for over 12 years. The principal clinical findings, the etiology and pathogenesis, the diagnostic-tools including US-guided fine-needle biopsy to preoperative differential diagnosis, are discussed.

Adrenal myelolipoma: a comprehensive review

“…Hypogonadism, primary hyperparathyroidism and pheochromocytoma were found in two cases each. Other reported endocrine diseases included Carney's complex [43], polycystic ovary syndrome [44], papillary thyroid cancer [45] and hyper-or hypothyroidism, Multiple Endocrine Neoplasia syndrome type 1 [46], and Nelson syndrome [47], but these are unlikely to represent real associations. Complaints and symptoms of hypercortisolism, hyperaldosteronism and hyperandrogenism typically vanished after the myelolipoma was removed.…”

The management of bilateral myelolipoma: Case report and review of the literature

“…The most frequent clinical feature of bilateral cases described is monolateral symptoms [6,8,11,13–16,18,21] (9 patients), usually abdominal discomfort, with the concomitant radiologic finding of a contralateral myelolipoma, as in the case at hand.…”

“…However, bilateral cases of adrenal myelolipoma has been reported. In our literature search, we found 37 cases [5–23,25] of bilateral myelolipoma, excluding the case at hand, mostly described in case reports. We excluded from the analysis 18 patients among those mentioned above because of insufficient data.…”

From painful breast erythematic lesions to incidental mammary findings

“…This is the breast ultrasound assessment of a 62-year old non-smoking female cidentaloma type in this case (1). A limited number of reports showed the association with breast cancer or ovarian lesions while this type of tumour is more frequent found at adrenal level (22,23,24). The risk of malignancy for a breast incidentaloma is high of 42% while for thyroid or ovarian incidentaloma is up to 25% for unselected series (2).…”