Giant Adrenal Myelolipoma: Is Laparoscopic Resection Possible?

Abstract

Background: Myelolipoma is a benign and uncommon tumor of the adrenal gland. The majority is small and asymptomatic and is diagnosed incidentally. However it can be large and produce symptoms. The laparoscopic adrenalectomy is the gold standard for its treatment but can be challenging if the lesion is big because of technical aspects and the associated malignancy risk. Case Report: We present a case of an asymptomatic 37 years old man, with past history of arterial hypertension, that performed an abdominal ultrasound that showed a huge mass on the right adrenal gland with 98×85×96 mm, consistent with a myelolipoma. The abdomino-pelvic tomography confirmed the diagnosis and the functional study revealed a marginal elevation of plasmatic nor-adrenaline and catecholamines. The MIBG scintigraphy was normal. The lesion was removed by laparoscopy. Conclusion: The giant adrenal myelolipoma is a rare tumor. Laparoscopic adrenalectomy has become the gold standard in management of most adrenal masses. Even for giant adrenal masses, it can be done in a safe way, provided that is performed by an experienced laparoscopic team.