Adrenal myelolipoma
Keywords:
adrenal myelolipoma, diagnostic imaging, tomography, neoplasms of the adrenal glands.Abstract
Introduction: Adrenal myelolipomas are unusual slow-growing benign tumors, composed of mature adipose tissue and hematopoietic cells.Objective: To present a new case of adrenal myelolipoma as well as to describe its clinical, imaging and applied therapeutic characteristics.
Clinical case: Female patient of 68 years old, with a history of hypertension, diabetes mellitus type 2 and obese, who was admitted to the General Surgery Service of the Hospital Militar Central Dr. Carlos J. Finlay, for presenting pain in the right hypochondrium. In the general physical examination, she presented a morbid obesity with a slight icteric dye of the skin and mucous membranes, and in the abdomen diffuse abdominal pain was observed, predominantly in the right hypochondrium without peritoneal reaction and negative Murphy sign; no palpated visceromegalias. Bi-basal crackles were heard in the thorax with diminished vesicular murmur. The blood tests performed showed liver tests with high values, and accelerated erythrosedimentation. In the computerized axial tomography an abdominal tumor was observed that impressed to correspond with the right adrenal gland, and that it mediates 110x135x90 mm. The right adrenalectomy was performed without complications. The histopathological diagnosis was an adrenal myelolipoma. The patient has evolved satisfactorily.
Conclusions: Adrenal myelolipoma does not present a characteristic clinical picture, so its finding is often incidental. Computed tomography is the technique of choice for the diagnosis of this lesion. In the masses greater than 6 centimeters, surgical treatment is indicated, with conventional surgery being a useful route for this.
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3. Larrea R, Sollet R, Paramio A, Duarte G, Fuentes M. Seudoaldosteronismo primario como forma de presentación de un mielolipoma suprarrenal. Informe de un caso y revisión de la literatura. Rev Cub Med. 1986[acceso: 25/04/2019]; 25(1):25-39. Disponible en: http://scielo.sld.cu/pdf/end/v29n3/a03_318.pdf
4. Román-González A, Londoño M, Díaz J, Builes Barrera CA, Gutiérrez J. Incidentaloma adrenal. Estado del Arte. Act Med Col. 2015 [acceso: 22/04/2019]; 40(4):318-25. Disponible en: https://www.redalyc.org/pdf/1631/163143293015.pdf
5. Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, SahdevA, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol. 2016 Aug [acceso: 11/05/2019]; 175(2):G1-G34. Disponible en: https://eje.bioscientifica.com/view/journals/eje/175/2/G1.xml
6. González Sánchez-Migallón E, Flores Pastor B, Miguel Perelló J, Jiménez Ballester MÁ, Pérez Guarinos CV, Flores Funes D, et al. Mielolipoma Suprarrenal Sangrante. Cir Esp. 2017[acceso: 27/04/2019];95 (Espec Congr):244. Disponible en: https://www.elsevier.es/es-revista-cirugia-espanola-36-congresos-xxi-reunion-nacional-cirugia-49-sesion-cirugia-endocrina-3445-comunicacion-mielolipoma-suprarrenal-sangrante-39096-pdf
7. Shaaban AM, Rezvani M, Tubay M, Elsayes KM, Woodward PJ, Menias CO. Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis. Radiographics. 2016 May-Jun[acceso: 03/04/2019];36(3):710-34 Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/27163589
8. Anis-Ul-Islam M, Qureshi AH, Zaidi SZ. Adrenal mielolipoma in a young male – a rare case scenerio. J Pak Med Assoc. 2016 Mar[acceso: 03/04/2019]; 66(3):342-4. Disponible en: https://www.jpma.org.pk/PdfDownload/7670.pdf
9. Sajjanar AB, Athanikar VS, Dinesh US, Nanjappa B, Patil PB. Non Functional Unilateral Adrenal Myelolipoma, A Case Report. J Clin Diagn Res. 2015 Jun [acceso: 19/03/2019];9(6):ED03-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525519/
10. Shenoy VG, Thota A, Shankar R, Desai MG. Adrenal myelolipoma: Controversies in its management. Indian J Urol. 2015 Apr-Jun [acceso: 12/04/2019];31(2):94-101. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397562/
11. García Rodríguez E, Herrero Redondo M, García Lorente F, Oliva Martí A, Eugena Martínez A, Viveros Castaño AM. Abordaje de un hallazgo suprarrenal casual. Med Gen Fam. 2017 [acceso: 07/05/2019];6(4): 161-166. Disponible en: http://mgyf.org/wp-content/uploads/2017/09/MGYF 2017_031.pdf
12. Khater N, Khauli R. Myelolipomas and other fatty tumours of the adrenals. Arab J Urol. 2011 Dec [acceso: 25/04/2019]; 9(4): 259-65. Disponible en: https://www.tandfonline.com/doi/full/10.1016/j.aju.2011.10.003
Published
2020-10-06
How to Cite
1.
Márquez Pedraza R, Hernández Puentes YZ, Enríquez Pérez FE. Adrenal myelolipoma. Rev Cubana Med Milit [Internet]. 2020 Oct. 6 [cited 2025 Jun. 8];49(4):e0200490. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/490
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