J Korean Soc Endocrinol.  2002 Aug;17(4):617-624.

Two Cases with Adrenal Myelolipoma Treated by Surgical Resection

Affiliations
  • 1Department of Internal Medicine, Cha Hospital, Pochon Cha University, Korea.
  • 2Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

An increasing number of incidental adrenal masses are found during the evaluation for unrelated problems, which is the result of the development of sensitive noninvasive methods for the imaging of abdominal lesions, such as ultrasonography, computed tomographic scanning, and MRI. When there is no evidence of adrenocortical or medullary dysfunction for such adrenal masses, they are commonly referred to as "incidentalomas". Among these incidentalomas, adrenal myelolipoma is a rare, benign, endocrinologically inactive tumor, the histological structure of which consists of mature adipose tissue cells and normal hemopoietic tissues resembling bone marrow. Even though most eventually prove to be nonhyperfunctioning adrenocortical adenomas, we must not exclude a more serious pathology. Because of the rarity of adrenal myelolipoma, its natural history, proper prognostic considerations and treatment recommendations still need to be investigated. We experienced 46 year-old man with abdominal discomfort, and a 26 year-old man with no specific symptoms, have large incidentalomas (>5 cm) in adrenal sites, detected by abdominal sonography for routine health work-up. The ACTH, cortisol, renin, aldosterenone, metanephrine, VMA and tumor marker levels were normal, which was suggestive of nonfunctional adrenal tumors. Surgical treatments were performed for rule out malignant adrenal tumors due to the tumor size (>5 cm) and hemorrhage within the tumors. The surgical pathology was that of adrenal myelolipomas. An adrenal myelolipoma is a rare, benign, nonfunctional adrenal tumor, but only three cases have been reported in Korea. We report two cases of adrenal myelolipoma found incidentally by surgical treatment for a large tumor size (>5 cm).


MeSH Terms

Adipose Tissue
Adrenocortical Adenoma
Adrenocorticotropic Hormone
Adult
Bone Marrow
Hemorrhage
Humans
Hydrocortisone
Korea
Magnetic Resonance Imaging
Metanephrine
Middle Aged
Myelolipoma*
Natural History
Pathology
Pathology, Surgical
Renin
Ultrasonography
Adrenocorticotropic Hormone
Hydrocortisone
Metanephrine
Renin
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