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Endocrine Jan 2018Adrenal myelolipoma is an invariably benign neoplasm of the adrenal gland that is the second most common primary adrenal incidentaloma following adrenocortical adenomas.... (Review)
Review
INTRODUCTION
Adrenal myelolipoma is an invariably benign neoplasm of the adrenal gland that is the second most common primary adrenal incidentaloma following adrenocortical adenomas. It is composed of elements of adipose tissue and extramedullary hematopoiesis. Hypotheses on stem cells and hormonal factors have been formulated regarding its pathogenesis that is still obscure. Despite its benign behavior, adrenal myelolipoma is clinically relevant as it might cause significant difficulties in the differential diagnosis of adrenal tumors.
METHODS
We have reviewed 420 cases reported between 1957 and 2017 on adrenal myelolipoma retrieved from PubMed and Scopus databases and also 20 of our case series to provide a comprehensive analysis of their pathology, epidemiological and clinical features.
RESULTS AND CONCLUSIONS
The average age for its diagnosis was 51 years, and no gender difference was observed. The average size of tumors was 10.2 cm. Congenital adrenal hyperplasia was associated to 10% of all cases analyzed, while other adrenal hypersecretory disorders (cortisol, aldosterone) were found in 7.5% of cases. Computed tomography and magnetic resonance imaging can be reliably used for its differential diagnosis. If the diagnosis of an adrenal myelolipoma is unambiguous, and no associated symptoms or hormonal activity are established, surgical intervention is usually not necessary.
Topics: Adipose Tissue; Adrenal Gland Neoplasms; Adrenal Glands; Adrenal Hyperplasia, Congenital; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Myelolipoma; Tomography, X-Ray Computed
PubMed: 29164520
DOI: 10.1007/s12020-017-1473-4 -
Mayo Clinic Proceedings Dec 2021
Topics: Adrenal Gland Neoplasms; Adrenal Glands; Adrenalectomy; Aged; Humans; Incidental Findings; Male; Myelolipoma
PubMed: 34863406
DOI: 10.1016/j.mayocp.2021.10.007 -
The American Journal of Case Reports May 2022BACKGROUND Myelolipoma is a benign tumor, commonly found in the supra-renal gland, which is composed of mature fatty tissue admixed with hematopoietic elements. However,... (Review)
Review
BACKGROUND Myelolipoma is a benign tumor, commonly found in the supra-renal gland, which is composed of mature fatty tissue admixed with hematopoietic elements. However, there are several extra-adrenal sites reported in the literature and thoracic myelolipoma is an unusual location for extra-adrenal myelolipoma. CASE REPORT We present the case of a 71-year-old man previously diagnosed with hypertension who was admitted due to a motor vehicle injury with a lumbar spine fracture. The patient developed non-ST segment elevation myocardial infarction during admission. A coronary angiogram revealed three-vessel disease. Triple coronary artery bypass grafting (CABG) surgery was planned. Upon opening the chest through median sternotomy, a retrosternal adherent mass was incidentally discovered. The mass was excised and histopathological evaluation showed it was myelolipoma in the anterior part of the mediastinum. CONCLUSIONS It is well known that myelolipoma occurs in extra-adrenal sites, and is rarely found at unexpected site, as in our case, which was found incidentally at the anterior mediastinum. With an extensive literature review, we found only 1 case located in the anterior mediastinum. It is crucial to know that myelolipoma can occur in the anterior mediastinum to avoid pitfalls with other differential diagnoses, especially when it is found incidentally and requires a frozen section examination, as it is difficult to diagnose through radiologic imaging only because it can overlap with tumors that are rich in either adipose tissue or hematopoietic elements. However, it affects patient management, and patients usually need only follow-up instead of going through invasive procedures for resection of non-functional tumors, especially in older patients or patients with comorbid diseases.
Topics: Adipose Tissue; Adrenal Gland Neoplasms; Aged; Diagnosis, Differential; Humans; Male; Mediastinum; Myelolipoma
PubMed: 35614634
DOI: 10.12659/AJCR.936005 -
AJR. American Journal of Roentgenology Sep 2016Myelolipoma is a benign tumor composed of fatty and hematopoietic elements. Presacral myelolipoma is rare, with fewer than 40 cases reported in the English literature.... (Review)
Review
OBJECTIVE
Myelolipoma is a benign tumor composed of fatty and hematopoietic elements. Presacral myelolipoma is rare, with fewer than 40 cases reported in the English literature. It is important to make an accurate diagnosis because there are malignant diseases included in the differential diagnosis of a presacral fatty mass, particularly liposarcoma.
CONCLUSION
The combination of a well-encapsulated fat-containing presacral mass, lack of coinciding hematologic disease, and uptake on sulfur colloid scintigraphy support the diagnosis of a presacral myelolipoma.
Topics: Diagnosis, Differential; Diagnostic Imaging; Humans; Myelolipoma; Pelvic Neoplasms
PubMed: 27248571
DOI: 10.2214/AJR.15.15280 -
The Journal of Surgical Research Jan 2017Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic... (Review)
Review
Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma. Pathologic analysis is an effective method to clarify the diagnosis. In view of the potential progressive enlargement of the lesion, most myelolipomas are removed by surgery, and this operation has frequently been accomplished by using video-assisted thoracic surgery.
Topics: Diagnosis, Differential; Humans; Lung Neoplasms; Mediastinal Neoplasms; Myelolipoma; Prognosis; Thoracic Surgery, Video-Assisted
PubMed: 27979469
DOI: 10.1016/j.jss.2016.08.076 -
Medicina 2023Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most...
Myelolipoma is a benign non-functional tumor. Most of them are asymptomatic and discovered incidentally, either through imaging studies or at autopsy. While it most commonly occurs in the adrenal gland, it has also been reported at extra-adrenal sites. We present the case of a 65-year-old woman with a primary mediastinal myelolipoma. Computer tomographic scan of the thorax showed an ovoid tumor with well-defined borders of 6.5 × 4.2 cm, located in the posterior mediastinum. A transthoracic biopsy of the lesion was made, and the microscopic observation revealed hematopoietic cells and mature adipose tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, histopathological examination is essential for the definitive diagnosis.
Topics: Female; Humans; Aged; Mediastinum; Myelolipoma; Thoracic Surgery, Video-Assisted; Radionuclide Imaging; Adrenal Gland Neoplasms
PubMed: 37379542
DOI: No ID Found -
The American Surgeon Apr 2003Myelolipomas are benign tumors composed of hematopoietic tissue and mature fatty tissue and occur primarily in the adrenal glands. Extra-adrenal sites for these tumors... (Review)
Review
Myelolipomas are benign tumors composed of hematopoietic tissue and mature fatty tissue and occur primarily in the adrenal glands. Extra-adrenal sites for these tumors are rare. To date 37 cases have been reported in the literature with more than half of these lesions being presacral in location. The purpose of this report is to raise awareness of this unusual tumor when formulating a differential diagnosis for retroperitoneal tumors. Presacral myelolipomas are easily confused with both primary and secondary malignant retroperitoneal tumors, which are far more common and aggressive neoplasms. Particular radiographic and histologic qualities distinguish this tumor from invasive malignancy. A case report is presented with a review of the literature on extra-adrenal myelolipomas.
Topics: Aged; Female; Humans; Myelolipoma; Sacrum; Soft Tissue Neoplasms
PubMed: 12716093
DOI: No ID Found -
The Lancet. Diabetes & Endocrinology Nov 2021Adrenal myelolipomas are benign, lipomatous tumours with elements of myeloid cells, most of which present as adrenal incidentalomas and comprise 3·3-6·5% of all... (Review)
Review
Adrenal myelolipomas are benign, lipomatous tumours with elements of myeloid cells, most of which present as adrenal incidentalomas and comprise 3·3-6·5% of all adrenal masses. Adrenal myelolipomas are usually unilateral (in 95% of cases), variable in size, most often found during midlife, and affect both sexes almost equally. On imaging, adrenal myelolipomas show pathognomonic imaging features consistent with the presence of macroscopic fat. Large adrenal myelolipomas can cause symptoms of mass effect, and can occasionally be complicated by haemorrhage. In the event of a concomitant adrenal cortical adenoma or hyperplasia, adrenal hormone excess might be detected in patients with adrenal myelolipoma. Patients with congenital adrenal hyperplasia exhibit a higher prevalence of adrenal myelolipomas than other patient groups, and are at risk of developing large and bilateral lesions. This Review discusses the pathogenesis, clinical presentation, and management of adrenal myelolipomas.
Topics: Adrenal Gland Neoplasms; Adrenal Hyperplasia, Congenital; Adrenocorticotropic Hormone; Aged; Female; Humans; Male; Middle Aged; Mutation; Myelolipoma; Prognosis; Proto-Oncogene Proteins; Tomography, X-Ray Computed
PubMed: 34450092
DOI: 10.1016/S2213-8587(21)00178-9 -
Cirugia Espanola Nov 2023
Topics: Humans; Myelolipoma; Adrenal Gland Neoplasms
PubMed: 36423875
DOI: 10.1016/j.cireng.2022.11.006 -
The Journal of Urology Nov 1993Extra-adrenal perirenal myelolipomas are rare benign tumors that consist of adipose and hematopoietic tissue. We report a case of perirenal myelolipoma in an otherwise... (Review)
Review
Extra-adrenal perirenal myelolipomas are rare benign tumors that consist of adipose and hematopoietic tissue. We report a case of perirenal myelolipoma in an otherwise healthy man and review the literature.
Topics: Aged; Humans; Kidney; Male; Myelolipoma; Retroperitoneal Neoplasms
PubMed: 8411435
DOI: 10.1016/s0022-5347(17)35823-8