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Cureus Aug 2023Adrenal myelolipoma is considered a benign neoplasm that accounts for 6% to 16% of adrenal incidentalomas, and it is the second most common incidental adrenal tumor...
Adrenal myelolipoma is considered a benign neoplasm that accounts for 6% to 16% of adrenal incidentalomas, and it is the second most common incidental adrenal tumor after adrenal adenomas. They are usually asymptomatic; however, in the presence of symptoms, significant growth, or complications, open surgical resection is indicated. We present the case of a 46-year-old woman with obesity and diabetes who experienced five years of left hemiabdominal pain, which was unsuccessfully treated symptomatically. A computed tomography scan revealed findings suggestive of pancreatic lipoma and a suggestive image of left adrenal myelolipoma. Resection of the tumor was performed using an anterior midline approach, and histopathological examination confirmed left adrenal myelolipoma. The presented case represents the typical presentation of these tumors in a patient in the fifth decade of life with obesity, diabetes, and nonspecific abdominal pain possibly related to the size of the lesion found. Surgical intervention was indicated due to the presence of symptoms, lesion size, contiguity with abdominal organs, and the absence of a precise diagnosis. An anterior midline approach was chosen, and histopathological examination provided a definitive diagnosis. Adrenal myelolipoma is a rare entity that is often asymptomatic and incidentally diagnosed through imaging studies. However, they should be resected when symptomatic to prevent complications. Open surgical resection is the preferred approach.
PubMed: 37692624
DOI: 10.7759/cureus.43240 -
Endocrine Regulations Jan 2017The term "adrenal incidentaloma" is a radiological term. Adrenal incidentalomas are adrenal tumors discovered in an imaging study that has been obtained for indications... (Review)
Review
The term "adrenal incidentaloma" is a radiological term. Adrenal incidentalomas are adrenal tumors discovered in an imaging study that has been obtained for indications exclusive to adrenal conditions (Udelsman 2001; Linos 2003; Bulow et al. 2006; Anagnostis et al. 2009). This definition excludes patients undergoing imaging testing as part of staging and work-up for cancer (Grumbach et al. 2003; Anagnostis et al. 2009). Papierska et al. (2013) have added the prerequisite that the size of a tumor must be "greater than 1cm in diameter", in order to be called incidentaloma. Although in the most cases these masses are non-hypersecreting and benign, they still represent an important clinical concern because of the risk of malignancy or hormone hyperfunction (Barzon et al. 2003). Th e adrenal tumors belong to the commonest incidental findings having been discovered (Kanagarajah et al. 2012).
Topics: 3-Iodobenzylguanidine; Addison Disease; Adrenal Cortex Neoplasms; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adrenocortical Adenoma; Adrenocortical Carcinoma; Cushing Syndrome; Diffusion Magnetic Resonance Imaging; Fluorodeoxyglucose F18; Hemorrhage; Humans; Hyperaldosteronism; Indium; Indium Radioisotopes; Lymphoma; Magnetic Resonance Imaging; Myelolipoma; Octreotide; Pheochromocytoma; Positron-Emission Tomography; Radionuclide Imaging; Radiopharmaceuticals; Tomography, X-Ray Computed; Ultrasonography
PubMed: 28222025
DOI: 10.1515/enr-2017-0005 -
BMC Surgery Jul 2014Myelolipoma is a rare neoplasm composed of yellowish adipose tissue and reddish-brown tissue corresponding to hematopoietic or hemorrhages. It typically occurs in... (Review)
Review
BACKGROUND
Myelolipoma is a rare neoplasm composed of yellowish adipose tissue and reddish-brown tissue corresponding to hematopoietic or hemorrhages. It typically occurs in adrenal glands as a solitary, well-circumscribed mass, and the thoracic location is extremely unusual.
CASE PRESENTATION
We present a rare case who is a 54 years old male with bilateral Myelolipoma of the posterior mediastinum. He underwent the surgery via video-assisted thoracic surgery both sides interval 3 months. Histological examination showed both tumors consisted of mature fat tissue and hematopoietic tissue, including myeloid, erythroid, and megakaryocytic elements surrounded. We discussed the etiology, histopathology, differential diagnosis and recommended management of extra-adrenal myelolipoma and analyzed the features of the thoracic myelolipoma including mediastinal and pulmonary location.
CONCLUSIONS
Literature review showed 16 similar cases, with a 2/1 male/female ratio and a mean age of 58 years. Eight of sixteen cases were observed in the mediastinum and six of sixteen cases were displayed in the pulmonary and one showed on the chest wall. CT and MRI scans are able to indicate the presence of extra-adrenal myelolipoma. Pathological analysis is an effective method to clarify the diagnosis. Observation and surgery are two regular treatment methods. Small, asymptomatic tumors should be monitored, while large tumors that cause unendurable symptoms may be removed by surgery.
Topics: Adrenal Gland Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Mediastinum; Middle Aged; Myelolipoma; Tomography, X-Ray Computed
PubMed: 25005140
DOI: 10.1186/1471-2482-14-42 -
Radiology Case Reports Mar 2022A 71-year-old female presented with chronic shortness of breath and underwent routine examination at the emergency department. A plain chest radiograph revealed a large...
A 71-year-old female presented with chronic shortness of breath and underwent routine examination at the emergency department. A plain chest radiograph revealed a large lobulated posterior mediastinal mass that was incidentally found to be unrelated to the main complaint. Further cross-sectional images were obtained to characterize the lesion, which revealed bilateral involvement of a prevertebral mixed attenuation large mass with minimal enhancement postcontrast administration. Images were not conclusive in which the patient underwent ultrasound-guided biopsy and further histopathological examination, which revealed a myelolipoma of the posterior mediastinum, a rare entity to be seen at that location. Here, we present the case of posterior mediastinal myelolipoma.
PubMed: 35003455
DOI: 10.1016/j.radcr.2021.12.001 -
JFMS Open Reports 2022A 15 shorthair cat presented after having fallen down the stairs. Examination by the referring veterinarian had demonstrated tachycardia and a large abdominal mass. The...
CASE SUMMARY
A 15 shorthair cat presented after having fallen down the stairs. Examination by the referring veterinarian had demonstrated tachycardia and a large abdominal mass. The cat was referred for investigations. Blood tests demonstrated hyperthyroidism. A large, poorly vascularised abdominal mass was identified on ultrasonography. The mass was hyperechoic compared with the normal liver; however, the origin could not be determined. Fine-needle aspirate biopsies of the mass demonstrated extramedullary haematopoiesis. Surgical exploration revealed a 12 cm × 8 cm × 8 cm pale mass arising from the spleen. Histopathology determined this was a giant splenic myelolipoma.
RELEVANCE AND NOVEL INFORMATION
Splenic myelolipoma is rarely reported in the domestic cat, with only five cases documented within the literature, and none of these having described giant myelolipoma. Indeed, giant myelolipomas are rarely reported in the human literature and are most commonly adrenal in origin. The pathogenesis of these masses is unclear; there have been several incidences in people with endocrine disorders, and it has been hypothesised that their occurrence may be related to endocrine stimulation. Here we report the first case of giant myelolipoma in a hyperthyroid cat.
PubMed: 36249674
DOI: 10.1177/20551169221127889 -
The Neuroradiology Journal Dec 2014Many reports have described adrenal myelolipomas but there have been only a few reports of extra-adrenal myelolipomas. We describe a 74-year-old woman who came to our... (Review)
Review
Many reports have described adrenal myelolipomas but there have been only a few reports of extra-adrenal myelolipomas. We describe a 74-year-old woman who came to our observation for MRI of the lumbar spine for typical lumbar back pain. In addition to signs of mild scoliosis and spondylo disc arthrosis, MR imaging revealed a presacral mass showing a heterogeneously high signal in all pulse sequences and almost completely suppressed on inversion recovery sequences for fat tissue. CT imaging confirmed the fatty nature of the lesion and no signs of bone involvement. These findings were most consistent with a diagnosis of a rare presacral myelolipoma as confirmed at histopathologic analysis. This work reports a case of one of the rarest presacral masses, emphasizing the role of imaging in the differential diagnosis of other presacral masses.
Topics: Aged; Female; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Myelolipoma; Spinal Neoplasms; Tomography, X-Ray Computed
PubMed: 25489902
DOI: 10.15274/NRJ-2014-10092 -
International Journal of Surgery Case... 2015Bilateral adrenal myelolipoma is a rare benign neoplasm. We presented the case of a young man affected by a bilateral myelolipoma and the analysis of the literature of...
INTRODUCTION
Bilateral adrenal myelolipoma is a rare benign neoplasm. We presented the case of a young man affected by a bilateral myelolipoma and the analysis of the literature of bilateral cases of myelolipoma. Our purpose is to give a suggestion of clear terms of reference regarding the management of this kind of bilateral neoplasm.
PRESENTATION OF CASE
We reported the case of a 41-year-old healthy man complained of abdominal pain in the upper quadrants. No significant alterations were found in routine blood and endocrinological tests. The imaging (CT and MRI) showed a huge right adrenal mass and a smaller lesion at the left adrenal gland. The preoperative pathological characterization was suggestive for a myelolipoma. A right open adrenalectomy was performed, and a radiological surveillance was planned for the left tumor. The pathological exam confirmed the diagnosis.
DISCUSSION
In literature, there are 36 cases described. The clinical presentation consisted of symptomatic tumors, incidentally diagnosed lesions or myelolipomas in patients with an associated endocrinal disorder. Symptomatic tumors or those bigger than 7cm, because of the potential risk of rupture, are usually treated surgically. In smaller (<7cm) and asymptomatic ones the surgical treatment is not univocal.
CONCLUSION
In the setting of the surgical treatment, it is important to preserve in some way the hormonal function. For that reason, the bilateral adrenalectomy has to be reserved for symptomatic or sizeable (>7cm) cases. As far as we know, this is the first review on bilateral myelolipomas.
PubMed: 25989259
DOI: 10.1016/j.ijscr.2015.04.021 -
Urology Case Reports Sep 2023Myelolipoma is a benign tumor composed of mature adipose tissue and normal hematopoietic components. It usually occurs in the adrenal glands but rarely in the...
Myelolipoma is a benign tumor composed of mature adipose tissue and normal hematopoietic components. It usually occurs in the adrenal glands but rarely in the extra-adrenal region. However, it is difficult to differentiate extra-adrenal myelolipoma from well-differentiated liposarcoma on the basis of the radiological findings. We report the case of a 66-year-old male with perirenal and extra-adrenal myelolipoma who underwent radical tumor resection with nephrectomy after a preoperative diagnosis of liposarcoma. Intraoperative assessment by the surgeon and intraoperative pathological evaluation are important considering the divergent prognoses of myelolipoma and liposarcoma.
PubMed: 37664534
DOI: 10.1016/j.eucr.2023.102523 -
The Pan African Medical Journal 2019Adrenal myelolipoma (MLS) is a rare, benign and non-functional neoplasm, composed of adipose tissue and myeloid. We report a rare case of adrenal myelolipoma of a...
Adrenal myelolipoma (MLS) is a rare, benign and non-functional neoplasm, composed of adipose tissue and myeloid. We report a rare case of adrenal myelolipoma of a 20-year-old female revealed with chronic abdominal pain. Computed tomography (CT) scan of the abdomen guided diagnosis and surgical resection was performed given symptomatic and bulky mass. Histological examination confirmed the diagnosis. At 18 months after the surgery, the patient had no evidence of recurrence. The diagnosis of MLS is radiological. Therapeutic abstention is the rule for a small, asymptomatic tumor. The surgical removal is indicated when it is bulky (exceeds 7cm), symptomatic or hormonal activity.
Topics: Abdominal Pain; Adrenal Gland Neoplasms; Chronic Disease; Female; Humans; Myelolipoma; Tomography, X-Ray Computed; Young Adult
PubMed: 32153720
DOI: 10.11604/pamj.2019.34.180.20891 -
Frontiers in Oncology 2022Adrenal myelolipomas are benign tumors composed mainly of lipomatous elements with myeloid cells. With the development of medical imaging technology, the detection rate...
INTRODUCTION
Adrenal myelolipomas are benign tumors composed mainly of lipomatous elements with myeloid cells. With the development of medical imaging technology, the detection rate has gradually increased. We report a case of adrenal myelolipoma successfully excised through the laparoscope and reviewed existing literature in recent ten years to summarize the feasibility of the laparoscopic approach for this tumor.
CASE PRESENTATION
Herein, we described a case of adrenal myelolipoma resected by laparoscope in a 63-year-old male patient. He did not have any other symptoms except the incidental finding of a left adrenal mass. An abdominal CT examination revealed a mixed-density lesion containing some amount of adipose tissue. In conjunction with the patient's willingness, we performed a laparoscopic operation to remove the lump. The definite diagnosis was confirmed as an adrenal myelolipoma according to the pathology. The patient recovered well postoperatively and without signs of recurrence at a 5-month follow-up.
CONCLUSION
Adrenal myelolipoma is commonly benign, asymptomatic, and hormonal inactivity. A surgical strategy is suggested for high-complication-risk patients. The laparoscopic approach is safe and effective with an obvious advantage over open procedures.
PubMed: 36544699
DOI: 10.3389/fonc.2022.1058211