Adrenal incidentaloma does it require surgical treatment? Case report and review of literature

Yalagachin, Gurushantappa; Bhat, Bharath Kumar

doi:10.1016/j.ijscr.2012.09.014

Cited by 10 publications

(15 citation statements)

References 8 publications

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“…They are usually detected by imaging methods or by autopsies performed for reasons unrelated to adrenal diseases, and therefore are also called "incidentalomas" [7]. Of all the incidentalomas, 70% correspond to nonfunctioning adenomas, 5 to 16% to functioning adenomas, 6% to pheochromocytomas, 5% to adrenocortical carcinomas, 2% to metastases, and the rest to other types of lesions, myelolipomas included in this category [8].…”

Section: Discussionmentioning

confidence: 99%

Adrenal Myelolipoma Diagnosed in a 72-Year-Old Patient with Abdominal Pain

2017

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Background: Adrenal myelolipoma is a rare benign tumor formed by hematopoietic tissue and mature adipose tissue. Usually is insidious and found occasionally on image exams, therefore is also called incidentaloma. Image studies and anatomopathological exam are important to define the diagnosis of adrenal myelolipoma. This study's objective was to report the case of this rare adrenal tumor and its main diagnostic means.Case: It was report a case about a 72-year-old patient, whose initial symptom was diffuse abdominal pain, nausea and vomiting, diagnosed with adrenal myelolipoma after image studies even in the absence of laboratory abnormalities, and submitted at a private hospital at Belém-PA. Conclusions:The adrenal myelolipoma, due its usual asymptomatic characteristics or its no-specifics symptoms, requires a meticulous analysis concerning both diagnosis and treatment. Thus, our case report corroborates the importance of the image studies in front of an obscure and difficult diagnosis, especially the computed tomography, and anatomopathological evaluation, since they are essential to the best decision making and consequently a better prognosis of the patient.

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Section: Discussionmentioning

confidence: 99%

Adrenal Myelolipoma Diagnosed in a 72-Year-Old Patient with Abdominal Pain

2017

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“…[13] On pathological examination, adrenal myelolipomas are macroscopically encapsulated with presence of fatty areas and tan brown areas, sometimes with haemorrhagic foci. [14] Size may vary from small subcentimeter tumours to large masses upto 21 cm. [2,3] Microscopically they are composed of adipocytes and haematopoetic elements in varying proportions.…”

Section: Discussionmentioning

confidence: 99%

“…[1,13] Adjacent adrenal tissue is usually evident. [1,14] Larger tumours may show haemorrhage, necrosis, cystic change, calcification, ossification. [14] For large tumours (>=6cm) or symptomatic tumours, surgical excision may be performed.…”

Section: Discussionmentioning

confidence: 99%

“…[1,14] Larger tumours may show haemorrhage, necrosis, cystic change, calcification, ossification. [14] For large tumours (>=6cm) or symptomatic tumours, surgical excision may be performed. [14] Smaller and asymptomatic tumours may be managed with careful patient follow up.…”

Section: Discussionmentioning

confidence: 99%

“…[14] For large tumours (>=6cm) or symptomatic tumours, surgical excision may be performed. [14] Smaller and asymptomatic tumours may be managed with careful patient follow up. Increase in size and atypical radiological features may be considered when making a clinical decision.…”

Section: Discussionmentioning

confidence: 99%

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Myelolipoma: a rare incidentally detected adrenal lesion

Gupta¹,

Punia²,

Sharma³

et al. 2017

APALM

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Routine investigations showed presence of pus cells in urine, mild anaemia with borderline leukocytosis on blood counts. ESR was elevated. Malarial parasite antigen test was negative. Blood glucose, serum electrolytes and liver enzymes were within normal range. Tests for viral markers 1 Department of Pathology, CK Birla Hospital, Jaipur. India 2 Department of Urology, CK Birla Hospital, Jaipur. India ABSTRACTAdrenal myelolipomas are benign, uncommon neoplams that are being increasingly detected due to frequent use of imaging studies. They are lipomatous tumours, that are usually asymptomatic and sometimes associated with endocrinological dysfunction.We present a case of middle aged gentleman, with accidentally detected adrenal mass and no hormonal disturbances. The patient was evaluated initially for fever. Laboratory investigations revealed evidence of urinary tract infection, which was conservatively managed. Ultrasound abdomen showed a hyperechoeic mass in suprarenal region with a hypoechoeic component. On further work up, MRI showed a well defined suprarenal mass with hyperintensity, possibly adrenal myelolipoma. The tumour was removed laparoscopically and histopathology revealed features of myelolipoma. The patient was discharged after an uneventful postoperative period. Adrenal myelolipomas are rare, benign tumours of adrenal gland diagnosed incidentally. Careful evaluation is important including imaging studies and endocrinological testing. Larger or symptomatic tumours can be excised surgically. Laparoscopic resection is a safe procedure in tumours considered for surgery, with favourable patient outcome.

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