Acute Abdominal Pain Secondary to Retroperitoneal Bleeding From a Giant Adrenal Lipoma With Review of Literature

Singaporewalla, Reyaz M; Thamboo, Thomas Paulraj; Rauff, A; Cheah, Wei-Keat; Mukherjee, J. J.

doi:10.1016/s1015-9584(09)60390-0

Cited by 22 publications

(30 citation statements)

References 7 publications

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“…There are 24 well-documented cases of adrenal lipomas in the English literature (Table 2) (Lange 1966, Prinz et al 1982, Avinoach et al 1989, Lam et al 1997, Ghavamian et al 1998, Sharma et al 1998, Büttner 1999, Lam & Lo 2001, Milathianakis et al 2002, Rodríguez-Calvo et al 2007, Shumaker et al 2008, Gupta et al 2009, Shah & Bhatti 2009, Singaporewalla et al 2009, Goldenberg et al 2011, Gunay et al 2011, Kapetanakis et al 2011, Patel et al 2011, Jain et al 2012, Zhao et al 2014. The first case in the English literature was reported by Lange in 1966(Lange 1966).…”

Section: Adrenal Lipomamentioning

confidence: 99%

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Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lam¹

2017

Endocrine-Related Cancer

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Adrenal lipomatous tumour is a group of adrenal tumours with a significant component of adipose tissue. According to the current World Health Organization (WHO) classification of tumours of endocrine organs, adrenal myelolipoma is the only entity amongst the group of tumours being described. In the literature, other more recently documented adrenal lipomatous tumours included 24 lipomas, 32 teratomas and 16 angiomyolipomas. Rare fatty tumours of the adrenal gland comprised liposarcoma, hibernoma, adrenocortical tumours with fat component and rare adrenal tumours with fat component. Myelolipoma comprises approximately 3% of primary adrenal tumour. It is noted more commonly in females and in the right adrenal gland. Approximately 40 bilateral myelolipomas were reported. The tumour is most frequently recorded in patients between fifth and seventh decades of life. Adrenal lipomas are often seen in males and in the right adrenal gland. They were commonly noted in patients in the sixth decade of life. The diagnosis could only be possible on examination of the surgically removed specimen. Adrenal teratomas were more common in females and with a bimodal age distribution. Slightly over 60% of the patients with adrenal teratoma are symptomatic. Adrenal angiomyolipomas were often symptomatic, more common in females and in the fifth decades of life. To conclude, adrenal lipomatous tumour is uncommon. They are often benign and non-functional. It is important to recognize the features of this group of lipomatous tumours in the adrenal gland as they are being detected on increasing incidence as a result of the wide-spread use of modern imaging modalities.

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Section: Adrenal Lipomamentioning

confidence: 99%

“…Most of the tumours are yellow with homogenous and soft cut sections. However, patches of haemorrhages could be seen (Lam et al 1997, Singaporewalla et al 2009, Kapetanakis et al 2011, Jain et al 2012. In one case, the bleeding from the vessels in the lipoma resulted in retroperitoneal bleeding (Singaporewalla et al 2009).…”

Section: :3mentioning

confidence: 99%

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lam¹

2017

Endocrine-Related Cancer

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“…They are usually composed of benign mature adipose tissue; however, unlike myelolipomas, lipomas do not have haematopoietic elements. Rarely, they can present with spontaneous hemorrhage [169]. Only 14 cases have been reported in the literature [170][171][172][173][174], and to date FDG PET findings have not been described.…”

Section: Lipomamentioning

confidence: 99%

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

et al. 2014

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PET/CT with (18)F-fluorodeoxyglucose (FDG) or using different radiocompounds has proven accuracy for detection of adrenal metastases in patients undergoing cancer staging. It can assist the diagnostic work-up in oncology patients by identifying distant metastases to the adrenal(s) and defining oligometastatic disease that may benefit from targeted intervention. In patients with incidentally discovered adrenal nodules, so-called adrenal "incidentaloma" FDG PET/CT is emerging as a useful test to distinguish benign from malignant etiology. Current published evidence suggests a role for FDG PET/CT in assessing the malignant potential of an adrenal lesion that has been 'indeterminately' categorized with unenhanced CT, adrenal protocol contrast-enhanced CT, or chemical-shift MRI. FDG PET/CT could be used to stratify patients with higher risk of malignancy for surgical intervention, while recommending surveillance for adrenal masses with low malignant potential. There are caveats for interpretation of the metabolic activity of an adrenal nodule on PET/CT that may lead to false-positive and false-negative interpretation. Adrenal lesions represent a wide spectrum of etiologies, and the typical appearances on PET/CT are still being described, therefore our goal was to summarize the current diagnostic strategies for evaluation of adrenal lesions and present metabolic and anatomic appearances of common and uncommon adrenal lesions. In spite of the emerging role of PET/CT to differentiate benign from malignant adrenal mass, especially in difficult cases, it should be emphasized that PET/CT is not needed for most patients and that many diagnostic problems can be resolved by CT and/or MR imaging.

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“…A total of 18 cases have been reported since 1966, as summarized in Table 1[2-4,6-14]. In all, 58% were asymptomatic or were found post-mortem [3,6,8,10,11].…”

Section: Introductionmentioning

confidence: 99%

A giant adrenal lipoma presenting in a woman with chronic mild postprandial abdominal pain: a case report

et al. 2011

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IntroductionAdrenal lipomas are rare, small, benign, non-functioning tumors, which must be histopathologically differentiated from other tumors such as myelolipomas or liposarcomas. They are usually identified incidentally during autopsy, imaging, or laparotomy. Occasionally, they may present acutely due to complications such as abdominal pain from retroperitoneal bleeding, or systemic symptoms of infection. We report a giant adrenal lipoma (to the best of our knowledge, the second largest in the literature) clinically presenting with chronic mild postprandial pain.Case presentationA 54-year-old Caucasian woman presented several times over a period of 10 years to various emergency departments complaining of long-term mild postprandial abdominal pain. Although clinical examinations were unrevealing, an abdominal computed tomography scan performed at her most recent presentation led to the identification of a large lipoma of the left adrenal gland, which occupied most of the retroperitoneal space. Myelolipoma was ruled out due to the absence of megakaryocytes, immature leukocytes, or erythrocytes. Liposarcoma was ruled out due to the absence of lipoblasts. The size of the lipoma (16 × 14 × 7 cm) is, to the best of our knowledge, the second largest reported to date. After surgical resection, our patient was relieved of her symptoms and remains healthy six years postoperatively.ConclusionPhysicians should be aware that differential diagnosis of mild chronic abdominal pain in patients presenting in emergency rooms may include large adrenal lipomas. When initial diagnostic investigation is not revealing, out-patient specialist evaluation should be planned to enable appropriate further investigations.

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Acute Abdominal Pain Secondary to Retroperitoneal Bleeding From a Giant Adrenal Lipoma With Review of Literature

Cited by 22 publications

References 7 publications

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Lipomatous tumours in adrenal gland: WHO updates and clinical implications

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

A giant adrenal lipoma presenting in a woman with chronic mild postprandial abdominal pain: a case report

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