Catecholamine-Secreting Adrenal Myelolipoma in the Absence of Hypertension: A Rare Case Report

Abstract

Adrenal myelolipoma (AML) is a benign neoplasm of the adrenal gland composed of fat and myeloid components. Most of these tumors are asymptomatic and non-secretory. We describe the case of a 22-year-old female who was being evaluated for right abdominal flank pain. She was detected with a 7.1 × 5.2 cm right adrenal mass with −55 mean HU on computed tomography (CT) scan, suggestive of myelolipoma. Her 24-hour urine normetanephrine level was elevated. Regular blood pressure monitoring was carried out, but she was normotensive. Right-sided unilateral adrenalectomy was performed. Histopathologic analysis confirmed the diagnosis of adrenal myelolipoma. Urine normetanephrine levels normalized post-surgery. Very few cases of catecholamine secretion by AML have been described in the literature. All of these cases had hypertension. To the best of our knowledge, this will be the first case reporting catecholamine secretion by AML in a normotensive patient.