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Endocrine-related Cancer Mar 2017Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO)... (Review)
Review
Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO) classification of tumours of endocrine organs, adrenal myelolipoma is the only entity amongst the group of tumours being described. In the literature, other more recently documented adrenal lipomatous tumours included 24 lipomas, 32 teratomas and 16 angiomyolipomas. Rare fatty tumours of the adrenal gland comprised liposarcoma, hibernoma, adrenocortical tumours with fat component and rare adrenal tumours with fat component. Myelolipoma comprises approximately 3% of primary adrenal tumour. It is noted more commonly in females and in the right adrenal gland. Approximately 40 bilateral myelolipomas were reported. The tumour is most frequently recorded in patients between fifth and seventh decades of life. Adrenal lipomas are often seen in males and in the right adrenal gland. They were commonly noted in patients in the sixth decade of life. The diagnosis could only be possible on examination of the surgically removed specimen. Adrenal teratomas were more common in females and with a bimodal age distribution. Slightly over 60% of the patients with adrenal teratoma are symptomatic. Adrenal angiomyolipomas were often symptomatic, more common in females and in the fifth decades of life. To conclude, adrenal lipomatous tumour is uncommon. They are often benign and non-functional. It is important to recognize the features of this group of lipomatous tumours in the adrenal gland as they are being detected on increasing incidence as a result of the wide-spread use of modern imaging modalities.
Topics: Adrenal Gland Neoplasms; Angiomyolipoma; Humans; Lipoma; Myelolipoma; Teratoma; World Health Organization
PubMed: 28143811
DOI: 10.1530/ERC-16-0564 -
Journal of Gastrointestinal Surgery :... Sep 2014
Topics: Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adult; Female; Humans; Myelolipoma; Tomography, X-Ray Computed; Virilism
PubMed: 24889790
DOI: 10.1007/s11605-014-2553-x -
Cirugia Espanola Nov 2014
Topics: Aged; Humans; Male; Myelolipoma; Sacrococcygeal Region; Sacrum; Spinal Neoplasms
PubMed: 24581879
DOI: 10.1016/j.ciresp.2013.04.019 -
Case Reports in Endocrinology 2022An adrenal myelolipoma presenting with suspicious features may pose a diagnostic challenge to surgeons and endocrinologists. In this case report of an adult patient with...
An adrenal myelolipoma presenting with suspicious features may pose a diagnostic challenge to surgeons and endocrinologists. In this case report of an adult patient with undiagnosed congenital adrenal hyperplasia presenting with bilateral adrenal masses, we review his radiographic and clinical findings which were highly suspicious for adrenal malignancy. Features of adrenal myelolipoma that may resemble malignant lesions are reviewed. This case report highlights important features of adrenal myelolipoma that the surgeon and endocrinologist should be aware of. The importance of avoiding overtreating adrenal myelolipomas presenting as tumors of uncertain malignant potential is crucial.
PubMed: 35083088
DOI: 10.1155/2022/4044602 -
Radiographics : a Review Publication of... 2016The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as... (Review)
Review
The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is easily recognized because of its characteristic imaging appearance. It typically is hyperechoic at ultrasonography and demonstrates low attenuation at computed tomography (-10 to -100 HU). Magnetic resonance imaging is a more ideal imaging modality because it has better soft-tissue image contrast and higher sensitivity for depicting (a) microscopic fat by using chemical shift imaging and (b) macroscopic fat by using fat-suppression techniques. Whether a lesion arises from a retroperitoneal organ or from the soft tissues of the retroperitoneal space (primary lesion) is determined by examining the relationship between the lesion and its surrounding structures. Multiple imaging signs help to determine the organ of origin, including the "beak sign," the "embedded organ sign," the "phantom (invisible) organ sign," and the "prominent feeding artery sign." Adrenal adenoma is the most common adrenal mass that contains microscopic fat, while myelolipoma is the most common adrenal mass that contains macroscopic fat. Other adrenal masses, such as pheochromocytoma and adrenocortical carcinoma, rarely contain fat. Renal angiomyolipoma is the most common fat-containing renal mass. Other fat-containing renal lesions, such as lipoma and liposarcoma, are rare. Fatty replacement of the pancreas and pancreatic lipomas are relatively common, whereas pancreatic teratomas are rare. Of the primary retroperitoneal fat-containing lesions, lipoma and liposarcoma are common, while other lesions are relatively rare. (©)RSNA, 2016.
Topics: Diagnosis, Differential; Diagnostic Imaging; Humans; Intra-Abdominal Fat; Lipomatosis; Retroperitoneal Space
PubMed: 27163589
DOI: 10.1148/rg.2016150149 -
International Journal of Surgery Case... Jan 2022We describe a case of a patient who presented with a mildly symptomatic, giant myelolipoma which was excised by laparoscopic approach without complications.
CASE PRESENTATION
We describe a case of a patient who presented with a mildly symptomatic, giant myelolipoma which was excised by laparoscopic approach without complications.
INTRODUCTION AND IMPORTANCE
Adrenal myelolipoma (AML) is a rare tumour composed by fat and myeloid tissues. Usually it is asymptomatic, so the diagnosis is mostly incidental. It is generally located in the right adrenal gland, but it can also be found bilaterally. If its size exceeds 10 cm it is defined as a "giant myelolipoma"; in this case its treatment of choice would be adrenalectomy with an open surgical approach.
CLINICAL DISCUSSION
Patient's signs and symptoms were mild pain in the right hypochondrium and a positive right Giordano's sign. The mass was detected by a contrast-enhanced CT scan. Once excised it measured 16 cm.
CONCLUSION
Laparoscopic adrenalectomy for giant myelolipoma is a safe approach if performed by an expert surgeon, with low risk of bleeding and a better outcome for the patient.
PubMed: 34952312
DOI: 10.1016/j.ijscr.2021.106678 -
Oncology Letters Apr 2015Intrapulmonary myelolipoma is a rare, benign tumor composed of mature adipose tissue and normal hematopoietic cells. To the best of our knowledge, 10 cases of...
Intrapulmonary myelolipoma is a rare, benign tumor composed of mature adipose tissue and normal hematopoietic cells. To the best of our knowledge, 10 cases of intrapulmonary myelolipoma, including the present case, have been reported to date, and the majority have focused on the pathological diagnosis of the disease. The radiological features of intrapulmonary myelolipoma have not been studied. Therefore, the present study reports a case of primary myelolipoma in the lung, and examines its computed tomography features and pathology. Furthermore, other potential diagnoses are discussed in the context of the relevant literature. The present report describes the case of a 57-year-old female who experienced chills, but no coughing or expectoration, with an intermittent fever of 38.6°C that had been apparent for 13 days. Chest CT scan revealed a benign nodule and bronchiectasis in the lower lobe of the right lung. The patient then underwent a lobectomy of the lower right lung by thoracoscopy. The histological analysis of the excised specimen identifid a myelolipoma consisting of mature adipose tissue and hematopoietic cells. There was no recurrence after 513 days of follow-up, as shown by CT.
PubMed: 25789022
DOI: 10.3892/ol.2015.2913 -
Presse Medicale (Paris, France : 1983) Nov 2015
Review
Topics: Abdominal Pain; Adult; Biopsy, Needle; Celiac Disease; Female; Humans; Myelolipoma; Sacrococcygeal Region; Soft Tissue Neoplasms; Tomography, X-Ray Computed; Weight Loss
PubMed: 26474833
DOI: 10.1016/j.lpm.2015.09.004 -
Annals of Medicine and Surgery (2012) Mar 2022Adrenal myelolipomas are rare non-functioning benign tumors composed of adipose and hematopoietic tissues. Most AMLs are discovered incidentally and represent the second...
INTRODUCTION
Adrenal myelolipomas are rare non-functioning benign tumors composed of adipose and hematopoietic tissues. Most AMLs are discovered incidentally and represent the second most common adrenal incidentaloma.
CASE PRESENTATION
A 58-years-old female patient, obese with a history of diabetes and blood hypertension presented with complaints of pain in the left flank. Abdominopelvic computed tomography showed a giant well-defined mass of the left adrenal gland with fat density suggesting adrenal myelolipoma. The patient underwent open left adrenalectomy. The pathological study confirmed the diagnosis of adrenal myelolipoma.
DISCUSSION
Most AMLs are asymptomatic, remain stable in size, or grow slowly. Mass effect symptoms and spontaneous rupture are observed more in larger AMLs. The most common symptoms observed are abdominal discomfort/pain, hypochondrial pain, and flank pain. Most of the AMLs are discovered incidentally and the radiological features are accurate in diagnosing AML in up to 90% of the cases, CT is more sensitive for detection than other imaging modalities. The open surgery approach is the standard treatment of choice for giant AML (>10cm) while the minimally invasive approach has been used in only a few cases.
CONCLUSION
The therapeutic management is discussed on a case-by-case basis. Surgical treatment is indicated for larger, symptomatic, or rapidly growing AMLs. Meanwhile smaller and asymptomatic AMLs are managed conservatively.
PubMed: 35198182
DOI: 10.1016/j.amsu.2022.103333 -
International Journal of Clinical and... 2018Mediastinal myelolipoma/extramedullary hematopoiesis presenting as a mass is infrequent and can lead to misdiagnosis. Here we describe a large series aiming to...
OBJECTIVES
Mediastinal myelolipoma/extramedullary hematopoiesis presenting as a mass is infrequent and can lead to misdiagnosis. Here we describe a large series aiming to illustrate the clinicopathologic features.
METHODS
We retrospectively searched mediastinal tumors and myelolipoma diagnosed at the Department of Pathology, West China Hospital from 2010 to 2015 and collected 14 mediastinal myelolipoma/extramedullary hematopoiesis cases presenting as an encapsulated mass among 1324 mediastinal mass diseases and 252 myelolipomas.
RESULTS
There were 8 females and 6 males aged from 35 to 67 years old, most of whom were diagnosed incidentally. Cross-sectional imaging revealed encapsulated masses located in the posterior mediastinum with fat and soft tissue density showing heterogeneous enhancement. Radiologic diagnosis was neurogenic tumor for most cases. All but one patient underwent surgery and postoperative pathologic findings showed fat and hematologic elements. Considering the accompanying hematologic disorders, 5 patients were diagnosed as extramedullary hematopoiesis and the remaining 9 as myelolipoma. The average hematopoietic tissue percentage in extramedullary hematopoiesis was 70%, significantly higher than it was in myelolipoma. Patients showed no sign of recurrence or metastasis apart from the patient with hepatocellular carcinoma.
CONCLUSIONS
Mediastinal myelolipoma/extramedullary hematopoiesis is a rare entity of solid tumors in the posterior mediastinum, affecting patients from their third decades, with no sex predilection and lacking unique clinical symptoms, and may be misdiagnosed as a malignant tumor on cross-sectional imaging. The final diagnosis relies on pathologic findings, and the precise classification of myelolipoma or extramedullary hematopoiesis relies on percentage of hematopoietic tissue and accompanying clinical symptoms. Surgery is the recommended treatment.
PubMed: 31938387
DOI: No ID Found