Spontaneous hemorrhage in adrenal myelolipoma treated with elective laparoscopic adrenalectomy following selective arterial embolization

Abstract

IntroductionAdrenal myelolipoma is a benign adrenal tumor that is typically asymptomatic and is rarely associated with hemorrhage or rupture. Here, we present a case of adrenal myelolipoma with spontaneous hemorrhage.Case presentationA 72‐year‐old man with a history of obesity and hypertension visited the Department of Emergency Medicine with a sudden onset of severe left flank pain. Enhanced computed tomography showed a left adrenal tumor containing a fat component with a focus of contrast medium visualized extravasation. The patient was diagnosed with adrenal myelolipoma with spontaneous hemorrhage. Selective adrenal arterial embolization was performed to manage the severe pain, and the condition immediately improved. Four months later, laparoscopic left adrenalectomy was performed via a transperitoneal approach. Histopathological examination confirmed the diagnosis of adrenal myelolipoma.ConclusionUrgent transarterial embolization followed by elective laparoscopic adrenalectomy is a safe and minimally invasive treatment option for managing adrenal myelolipomas with hemorrhage.