Korean J Urol.  2011 Aug;52(8):582-585. 10.4111/kju.2011.52.8.582.

Myelolipomas of Both Adrenal Glands

• Cha JS
• Shin YS
• Kim MK
• Kim HJ

• KMID: 1988966
• DOI: http://doi.org/10.4111/kju.2011.52.8.582

Abstract

Adrenal myelolipoma is a rare, nonfunctional benign tumor that is composed of mature adipose tissue and hematopoietic elements. In the past, these tumors were accidentally discovered at autopsy. Today, they are found much more frequently and incidentally, mainly because of the widespread use of noninvasive imaging with ultrasonography, computed tomography, and magnetic resonance imaging. Most lesions are asymptomatic, small, and unilateral, but a number of bilateral tumors have been reported. We report here on a case of a 48-year-old man with incidentally found myelolipomas of both adrenal glands. In particular, a giant myelolipoma of the left adrenal gland was treated by transperitoneal laparoscopic adrenalectomy.

Keyword

Adrenal glands; Laparoscopy; Myelolipoma

MeSH Terms

Adipose Tissue
Adrenal Glands
Adrenalectomy
Autopsy
Humans
Laparoscopy
Magnetic Resonance Imaging
Middle Aged
Myelolipoma

Figure

• 

  FIG. 1 The CT scan shows bilateral masses in the adrenal glands with densities indicating adipose tissue. (A) Axial section image. (B) Coronal section image.

• 

  FIG. 2 The magnetic resonance imaging shows the masses having high signal intensity on the T2 weighted image (A) and low signal intensity on the T1 fat-suppressed image (B).

• 

  FIG. 3 (A) Macroscopic view of the left adrenal myelolipoma. (B) Myelolipoma composed of mature fat mixed with hematopoietic element including megakaryocytes. Note the normal adrenal cortical tissue (right) (H&E, ×200).

Reference

1. Oberling C. The formation of myelolipomas. Bull Assoc Fr Etud Cancer. 1929. 18:234–246.

2. Olsson CA, Krane RJ, Klugo RC, Selikowitz SM. Adrenal myelolipoma. Surgery. 1973. 73:665–670.

3. Daneshmand S, Quek ML. Adrenal myelolipoma: diagnosis and management. Urol J. 2006. 3:71–74.

4. Ioannidis O, Papaemmanouil S, Chatzopoulos S, Paraskevas G, Konstantara A, Kotronis A, et al. Giant bilateral symptomatic adrenal myelolipomas associated with congenital adrenal hyperplasia. Pathol Oncol Res. 2011. Epub ahead of print.

5. Kammen BF, Elder DE, Franker DL, Siegelman ES. Extraadrenal myelolipoma: MR imaging findings. AJR Am J Roentgenol. 1998. 171:721–723.

6. Akamatsu H, Koseki M, Nakaba H, Sunada S, Ito A, Teramoto S, et al. Giant adrenal myelolipoma: report of a case. Surg Today. 2004. 34:283–285.

7. Mo KI, Kim DG, Lee KS, Kwen SW, Seo YJ. Adrenal myelolipoma treated with hand-assisted transperitoneal laparoscopic adrenalectomy. Korean J Urol. 2006. 47:791–793.

8. Hisamatsu H, Sakai H, Tsuda S, Shigematsu K, Kanetake H. Combined adrenal adenoma and myelolipoma in a patient with Cushing's syndrome: case report and review of the literature. Int J Urol. 2004. 11:416–418.

9. Talwalkar SS, Shaheen SP 2nd. Extra-adrenal myelolipoma in the renal hilum: a case report and review of the literature. Arch Pathol Lab Med. 2006. 130:1049–1052.

10. Kim HK, Lee YH, Jung KJ, Sung NK, Kim OD, Cho CH. Adrenal collision tumor consisted of adrenocortical carcinoma and myelolipoma: a case report. J Korean Radiol Soc. 2002. 47:399–401.