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Iranian Journal of Kidney Diseases Jan 2020As a rare and normally-benign and functionless tumor, primary adrenal myelolipoma comprises adipose tissue and myeloid cells, and its diagnosis is usually difficult... (Review)
Review
As a rare and normally-benign and functionless tumor, primary adrenal myelolipoma comprises adipose tissue and myeloid cells, and its diagnosis is usually difficult owing to its asymptomatic nature. Imaging techniques can detect these masses in over 90% of the cases. CT scan is the most sensitive imaging technique, which can display the tissue nature of this tumor with a high resolution. The present case report involves a 45-year-old woman with bilateral adrenal myelolipoma diagnosed with imaging methods.
Topics: Adrenal Gland Neoplasms; Female; Humans; Middle Aged; Myelolipoma; Tomography, X-Ray Computed
PubMed: 32156843
DOI: No ID Found -
The Pan African Medical Journal 2017Adrenal myelolipoma is a rare benign non secreting tumor. It is often unexpectedly detected. Pathophysiologically, it is adrenal cortex cell metaplasia into...
Adrenal myelolipoma is a rare benign non secreting tumor. It is often unexpectedly detected. Pathophysiologically, it is adrenal cortex cell metaplasia into reticuloendothelial cells, resulting from infection, chronic stress or adrenal gland degeneration. The mean age at diagnosis is late forties. Histologically, the tumor is composed of mature fat tissue associated with normal haematopoietic tissue. Tumor echogenicity depends on the predominance of the greasy or myeloid component. Its diagnosis is based on CT scan that identifies the fat percentage. However, these radiological aspects may lead to diagnostic confusion with kidney angiomyolipoma, lipoma and liposarcoma, hence the key role of MRI. Surgical resection of myelolipoma is usually performed and is indicated when tumor is voluminous, compressive or at risk of hemorrhage. We here report the case of AL A, 75 years old, hospitalized for adrenal mass revealed by right back pain radiating to the right hypochondrium, without signs of endocrine hypersecretion. Clinical examination showed sensitivity of the right lumbar fossa. Pheochromocytoma and corticosurrenaloma assessment was without abnormalities, including 24-hours urinary methoxyl derivatives and dexamethasone suppression test. The patient underwent coelioscopy; anatomo-pathological examination showed adrenal myelolipoma.
Topics: Adrenal Gland Neoplasms; Aged; Back Pain; Humans; Laparoscopy; Magnetic Resonance Imaging; Male; Myelolipoma; Tomography, X-Ray Computed
PubMed: 29541300
DOI: 10.11604/pamj.2017.28.153.13035 -
Annals of Medicine and Surgery (2012) Sep 2020Myelolipomas are very rare benign tumours consisting of hematopoietic cells and mature adipose tissues. They are most commonly found in the adrenal glands. However,...
INTRODUCTION
Myelolipomas are very rare benign tumours consisting of hematopoietic cells and mature adipose tissues. They are most commonly found in the adrenal glands. However, there have been several reported cases of extra-adrenal myelolipomas, most commonly in the presacral region. Nearly all presacral lesions are small and asymptomatic; thus, most are discovered incidentally on imaging studies.
PRESENTATION OF CASE
We report two cases of presacral myelolipomas. The first is a 48-year-old female presenting with atypical back pain, found to have a mass in her presacral region with a size of 3,3 cm. The second case is a 59-year-old female, who presented for evaluation of a hip fracture, found to have a 4,7 cm presacral lesion. Both presacral myelolipomas were discovered incidentally and were confirmed by percutaneous guided fine-needle aspiration biopsy. Both were treated conservatively.
DISCUSSION
Accepted indications for the surgical excision of myelolipomas are symptomatic tumour, size >4 cm, metabolically active tumour, and a suspicion of malignancy on an imaging study. However, previous reports have documented that nearly half of the conservatively managed myelolipomas with a mean initial size of 5,1 cm, has increased in size or became symptomatic over a 3-years period.
CONCLUSION
We conclude that symptomatic presacral myelolipomas or lesions larger than 4 cm should be en-bloc resected, and we present an intuitive decision-making algorithm.
PubMed: 32904073
DOI: 10.1016/j.amsu.2020.07.002 -
BMC Surgery Jun 2017Adrenal myelolipoma is an uncommon, benign, and hormonally non-functioning tumor that is composed of mature adipose tissue and normal hematopoietic tissue. Most cases to... (Review)
Review
BACKGROUND
Adrenal myelolipoma is an uncommon, benign, and hormonally non-functioning tumor that is composed of mature adipose tissue and normal hematopoietic tissue. Most cases to date are asymptomatic or have epigastric pain. Acute hemorrhage is the most dramatic manifestation of adrenal myelolipoma; though, it is a rare entity. Hemorrhagic shock due to adrenal myelolipoma, to our knowledge, was much less mentioned so far. Persistent bleeding and uncontrollable hypotension are considered to be absolute indications for immediate surgical operation.
CASE PRESENTATION
Herein we presented a 32-year-old male patient with initial symptoms of nausea, vomiting, and epigastric pain progressing to altered consciousness and hypotension during ER course. Hemorrhagic shock due to a giant adrenal myelolipoma, R’t was diagnosed. Emergent exploratory laparotomy was executed, and en bloc excision of tumor was done.
CONCLUSION
Adrenal myelolipoma might be diagnosed as a adjunction to other main causes of illness; furthermore, adrenal myelolipoma could be asymptomatic in lifetime. In our case, however, manifesting as hemorrhage shock was challenging to diagnose step by step; instead, maintaining vital organs perfusion and identifying bleeding sources were to be done. Management of myelolipoma should be done on a case-to-case basis.
Topics: Abdominal Pain; Adrenal Gland Neoplasms; Adult; Hemoperitoneum; Humans; Laparotomy; Male; Myelolipoma; Shock, Hemorrhagic
PubMed: 28651560
DOI: 10.1186/s12893-017-0270-6 -
Medicine Apr 2018Extra-adrenal myelolipoma in the presacral area often raises a concern for liposarcoma because they have similar radiologic features.
RATIONALE
Extra-adrenal myelolipoma in the presacral area often raises a concern for liposarcoma because they have similar radiologic features.
PATIENT CONCERNS
A 70-year-old woman with multiple abdominal surgeries in the past presented with persistent lower abdominal pain and anemia. A presacral mass, found on a pelvic magnetic resonance image (MRI), was suspicious of liposarcoma, as it is the most common fat containing mass in the presacral area. It is often difficult to make a diagnosis of myelolipoma just based on the radiological studies, which necessitates a histopathologic examination of the resected mass for a definitive diagnosis.
DIAGNOSES
Myelolipoma is an encapsulated, benign tumor containing mature adipocytes and hematologic cells. Most of the patients with myelolipoma remain asymptomatic but continued growth of tumor without local invasion can lead to compression of nearby structures, causing persistent pain.
INTERVENTIONS
Asymptomatic patients do not require intervention but surgical resection is indicated for persistent pain or hemorrhage inside the tumor. Our patient had 2 indications for surgery - persistent pain as well as a provisional diagnosis of liposarcoma. After the surgical resection, pelvic pain was resolved, and a diagnosis of myelolipoma was made based on histopathologic examination.
OUTCOMES
Patient was reassured that it was myelolipoma, a benign tumor, not requiring subsequent surveillance for recurrence.
LESSONS
Despite advancement in imaging techniques, and knowledge of the radiological features of myelolipoma, it still remains as a challenge for clinicians to make the distinction between liposarcoma and myelolipoma only based on diagnostic radiology. Although myelolipoma is a benign tumor, if patient suffers from persistent pain due to local mass effect, surgical resection is required.
Topics: Abdominal Neoplasms; Aged; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Myelolipoma; Neoplasm Staging; Pelvic Pain; Prognosis; Sacrum
PubMed: 29642172
DOI: 10.1097/MD.0000000000010337 -
BMC Pulmonary Medicine Aug 2023Extra-adrenal myelolipoma is an unusual entity, and endobronchial myelolipoma is rarer, which is often ignored by clinicians, delaying the disease and affecting the... (Review)
Review
BACKGROUND
Extra-adrenal myelolipoma is an unusual entity, and endobronchial myelolipoma is rarer, which is often ignored by clinicians, delaying the disease and affecting the prognosis.
CASE PRESENTATION
A 71-year-old man with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus, with recurrent fever, cough, and expectoration for more than 2 weeks experienced relief in cough, phlegm reduction, and glycemic control with anti-inflammatory treatment. Further examination revealed that new growths obstructing all lobar bronchi impaired flexible bronchoscope entry. In order to relieve the patient's symptoms, under general anesthesia, we performed liquid nitrogen cryobiopsy at multiple bronchial openings, and then used argon plasma coagulation (APC) to achieve hemostasis. The pathological diagnosis was bronchial myelolipoma. The largest volume of the resected tissue was a mass measuring 0.6 cm × 0.4 cm × 0.3 cm at the bronchial opening of the upper lobe of the left lung. The patient's condition was stable and the symptoms were partially relieved after surgery. No recurrence was observed during the 12-month follow-up, although the long-term treatment efficacy is unknown.
CONCLUSION
Pathological biopsy is key to the diagnosis of endobronchial myelolipoma, and the development of the endobronchial myelolipomas may have been associated with long-term poor control of steroid levels in this patient.
Topics: Male; Humans; Aged; Myelolipoma; Cough; Diabetes Mellitus, Type 2; Bronchi; Lipoma
PubMed: 37653374
DOI: 10.1186/s12890-023-02608-z -
Medicine Jul 2019Primary hepatic myelolipoma is a rare benign neoplasm comprising mature adipose tissue and marrow components in various proportions. Chemical shift imaging (CSI) can... (Review)
Review
RATIONALE
Primary hepatic myelolipoma is a rare benign neoplasm comprising mature adipose tissue and marrow components in various proportions. Chemical shift imaging (CSI) can distinguish the lipid within the tumor clearly; however, there have been no reports on the CSI of hepatic myelolipoma.
PATIENT CONCERN
A 20-year-old woman visited our hospital after discovering a space-occupying lesion in the liver with a history of more than 1 year. She felt distension pain and discomfort under the xiphoid process, accompanied by nausea, vomiting, and occasional chest oppression.
DIAGNOSIS
The tumor showed a well-defined mass with a pseudocapsule and a heterogeneous appearance on both T1- and T2-weighted magnetic resonance (MR) images. CSI analysis showed a signal decline within the tumor. Based on the histopathology, the tumor was diagnosed as hepatic myelolipoma.
INTERVENTIONS AND OUTCOMES
The patient underwent a right hepatectomy, and the postoperative vital signs were stable. Two weeks later, the patient was discharged safely.
LESSONS
Although hepatic myelolipoma is extremely rare, this condition should be considered in differential diagnosis when CSI shows that hepatic lesions contain fatty.
Topics: Female; Hepatectomy; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Myelolipoma; Young Adult
PubMed: 31335715
DOI: 10.1097/MD.0000000000016497 -
Asian Journal of Urology Jan 2022
PubMed: 35198403
DOI: 10.1016/j.ajur.2021.04.006 -
Acta Endocrinologica (Bucharest,... 2022An adrenal collision tumor is a rare entity. We present a rare combination of giant adrenal ganglioneuroma (GN) and myelolipoma. GN is a rare benign tumor of the adrenal...
BACKGROUND
An adrenal collision tumor is a rare entity. We present a rare combination of giant adrenal ganglioneuroma (GN) and myelolipoma. GN is a rare benign tumor of the adrenal medulla that originates from primitive neural crest cells, while myelolipoma is a benign tumor of the adrenal cortex comprising of mature adipose tissue and blood components.
CASE REPORT
We present a case of a 52-year-old male who presented with generalized body swelling with episodes of vomiting and diarrhea. There was no history of abdominal pain or any significant history. Routine laboratory investigations and endocrine workup were within normal limits. MRI was performed for unexplained symptoms, and which revealed a solid homogeneous mass measuring 9x7x4.5cm arising from the adrenal gland. A diagnosis of myxoid adrenocortical neoplasm was suggested, and laparoscopic left adrenalectomy was performed based on imaging findings. The final diagnosis of coexisting giant adrenal GN with myelolipoma was made on histopathological examination, which was further confirmed by immunohistochemistry.
CONCLUSION
Ganglioneuroma coexistence with myelolipoma is a rare finding in the adrenal gland. Therefore, histopathology is imperative in such cases for a definitive diagnosis.
PubMed: 36699157
DOI: 10.4183/aeb.2022.379 -
BMJ Case Reports Oct 2021
Topics: Adrenal Gland Neoplasms; Humans; Lipoma; Myelolipoma
PubMed: 34645633
DOI: 10.1136/bcr-2021-245181