Management of bilateral adrenal myelolipoma without endocrine disorder: About a rare case report

Boukhannous, Ibrahim; Chennoufi, Mehdi; Mokhtari, Mohamed; Moudane, Anouar El; Barki, Ali

doi:10.1016/j.eucr.2021.101755

Cited by 5 publications

(23 citation statements)

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“…Adrenal myelolipoma is a rare tumor with fat density under the CT scan and is clinically relevant. Because of the advancement of imaging technology and its popularization, reports of AML have been increased during the last decades (5,(9)(10)(11)(12)(13)(14). There exists a dilemma that diagnosis of AML is difficult because of its benign properties and reliability of the pathological examination.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Myelolipoma: 369 Cases From a High-Volume Center

Lin

Gong

Cheng

et al. 2021

Front. Cardiovasc. Med.

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Background: Adrenal myelolipoma (AML) is a nonfunctional benign neoplasm from the adrenal cortex, composed of mature fat and hematopoietic tissue. Usually, patients have no symptoms. However, some patients with hypertension and blood pressure normalize after AML surgery, indicating some connections between AML and hypertension.Materials and Methods: This was a retrospective cohort study of 369 patients diagnosed with AML from September 2008 to December 2018 collected in the Urology Department of West China Hospital, Chengdu, Sichuan, China. We collected clinical records of patients before surgery. Postoperative follow-up was also carried out for those with hypertension and whether patients needed to take antihypertensive drugs and postoperative blood pressure were recorded. We aim to explore the characteristics of both patients with AML having hypertension and having remission of hypertension in 1 year after surgery.Results: There were 369 patients with AML included in the study, 156 men and 213 women, aged 49.86 ± 11.61 years old. Among them, 121 (32.8%) patients presented with hypertension. Body mass index was significantly higher in the hypertension group than that in the nonhypertension group, even after adjusting other variables (26.26 ± 3.43 vs. 24.28 ± 3.38 kg/m2, P < 0.001 for both univariate and multivariate analyses). Sixty patients were followed up for 1–9 years, with a median follow-up of 52 months. The duration of hypertension in the remission group was shorter than that in the non-remission group (P = 0.020), and the tumor lateralization was significantly different between the two groups (P = 0.005).Conclusions: Nearly one-third of patients with AML suffered from hypertension in our study, and there existed some potential links between AML and hypertension. To be more specific, AML-related hypertension was more likely to result from obesity and renal compression by perirenal fat than from endocrine disorders or blood vessels compression. Patients with AML and with more than 3 years of hypertension might have less possibility to recover.

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Section: Discussionmentioning

confidence: 99%

Adrenal Myelolipoma: 369 Cases From a High-Volume Center

Lin

Gong

Cheng

et al. 2021

Front. Cardiovasc. Med.

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Section: Discussionunclassified

“…Los mielolipomas de la GS fueron descritos por primera vez por Edgar Von Gierkey en 1905, y adquirieron la denominación de mielolipoma en 1929 por Charles Oberlin 6,7,8,12 . Es un tumor originado en la corteza suprarrenal, benigno, compuesto por una proporción variable de tejido adiposo maduro y hematopoyético 4,8,13 . La etiología del mielolipoma se desconoce, aunque existen varias hipótesis que incluyen: la degeneración de los tejidos epiteliales de la corteza suprarrenal, trastornos hormonales, la hematopoyesis extramedular debido a la proliferación autónoma de células de la médula ósea trans- feridas durante la embriogénesis; se plantea también relación etiopatogénica con las células madres.…”

Section: Discussionunclassified

“…Estos suelen ser conocidos como incidentalomas suprarrenales, presentes en el 2 al 10% de la población [1][2][3][4] . El mielolipoma es uno de los tumores que pueden afectar a las GS, de origen mesenquimatoso, compuestos por tejido adiposo maduro y células hematopoyéticas, son benignos, generalmente no funcionales, raros y de crecimiento lento [4][5][6][7][8] . Con mayor frecuencia afecta a las GS, pero también se han informado mielolipomas extraadrenales localizados en el retroperitoneo, área presacra, bazo, riñón, estómago, hígado, pulmón, mediastino, cavidad nasal, huesos y testículo 4,6,9,10 .…”

Section: Introductionunclassified

“…La incidencia del mielolipoma de la GS representa el 2% de todos los incidentalomas suprarrenales 8,11 , la incidencia en autopsias es de 0,08 a 0,2% 6,7,9,12 y se encuentra con mayor frecuencia entre los 50 y 70 años 5,6 .…”

Section: Introductionunclassified

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Mielolipoma gigante unilateral de la glándula suprarrenal. Reporte de caso

et al. 2023

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Introducción: Los tumores de la glándula suprarrenal son inusuales y por lo general son hallados de forma incidental por estudios de imágenes. Dentro de este grupo los mielolipomas son uno de los tumores más raros, considerados el 2% de los tumores suprarrenales.Caso clínico: Presentamos una paciente femenina de 60 años de edad con antecedentes de dolor a tipo cólico de forma esporádica a nivel del hipocondrio derecho. La ecografía abdominal detectó colelitiasis y una masa sugerente de adenoma suprarrenal izquierdo. La tomografía abdominal corroboró el tumor suprarrenal gigante y la litiasis vesicular. Se realizó suprarrenalectomía y colecistectomía convencional sin complicaciones. El diagnóstico histopatológico mostró un mielolipoma suprarrenal y una colecistitis crónica.Discusión: El mielolipoma suprarrenal es infrecuente, la etiología se desconoce, por lo general es asintomático y su hallazgo es incidental, habitualmente son unilaterales, menores a 4cm y la incidencia aumenta con la edad.Conclusiones: Cuando los mielolipomas alcanzan dimensiones mayores de 10cm se recomienda realizar una suprarrenalectomía convencional.

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Effect of Surgical Treatment on Endocrine Functional Hormone Indexes in Female Patients with Endocrine Disorders Caused by Sellar Region Tumors

2023

CNR

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Objective: To explore, evaluate and analyze the effects of surgical treatment on endocrine functional hormone indexes in female patients with endocrine disorders caused by sellar region tumors. Methods: 600 female patients with endocrine disorders caused by sellar region tumors who were admitted to the Department of Neurosurgery of Yunan Shuifu People’s Hosptial and Beijing University of Chinese Medicine Third Affiliated Hospital from March 2018 to March 2023 were selected as the research subjects. The patients were divided into two groups, each consisting of 300 cases: the microscopic group received treatment via the microscopic transsphenoidal approach, while the endoscopic group underwent treatment through the neuroendoscopic transsphenoidal approach. The efficacy of both treatments and surgery-related indicators of the patients of both groups were compared. Besides, the endocrine functional hormone indicators, including estradiol (E2) and follicle-stimulating hormone (FSH) levels, were compared between the two groups before operation and 1 week after operation. Results: The efficacy of the treatment received by the endoscopic group was higher than that of the microscopic group, but the difference was not statistically significant (P > 0.05). The duration of operation and postoperative hospital stay of the endoscopic group were shorter than those of the microscopic group, and the intraoperative blood loss was less than that of the microscopic group, the differences were statistically significant (P < 0.05). The postoperative E2 and FSH levels of the two groups were higher than those before operation, and the E2 and FSH levels of the endoscopic group after treatment were higher than those of the microscopic group, and the difference was statistically significant (P < 0.05). Conclusion: The neuroendoscopic transsphenoidal approach for treating female patients with endocrine disorders caused by sellar region tumors proves to be more effective than the microscopic transsphenoidal approach. It enhances the levels of endocrine functional hormones and alleviates clinical symptoms, making it a promising approach worthy of wider adoption.

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Management of bilateral adrenal myelolipoma without endocrine disorder: About a rare case report

Cited by 5 publications

References 3 publications

Adrenal Myelolipoma: 369 Cases From a High-Volume Center

Adrenal Myelolipoma: 369 Cases From a High-Volume Center

Mielolipoma gigante unilateral de la glándula suprarrenal. Reporte de caso

Effect of Surgical Treatment on Endocrine Functional Hormone Indexes in Female Patients with Endocrine Disorders Caused by Sellar Region Tumors

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