Bilateral giant adrenal myelolipomas presenting as an enlarging ventral hernia: Radiologic-pathologic correlation and literature review

Anterior Transabdominal Laparoscopic Adrenalectomy, without Ligatures, for a Symptomatic Right Adrenal Myelolipoma with Intratumoral Hemorrhage

“…The extra-adrenal localization of these histologically benign tumors may be presacral (up to 50% of the extra-adrenal localization) (2), splenic, gastric, pulmonary, hepatic, retroperitoneal, testicular (1,7,8). Most of the time they are asymptomatic, unilateral (more frequent on the right side), but they can also be bilateral (9,10). Their size is, in general, under 4 cm, but they can also reach greater size (the greatest myelolipoma described in the literature was of 31x24.5x11.5 cm and weighted 6 kg) (5,6,10,11).…”

“…Most of the time they are asymptomatic, unilateral (more frequent on the right side), but they can also be bilateral (9,10). Their size is, in general, under 4 cm, but they can also reach greater size (the greatest myelolipoma described in the literature was of 31x24.5x11.5 cm and weighted 6 kg) (5,6,10,11). Symptomatic forms usually present with unregulated pain in the epigastrium and flanks (right or left depending of the localization of the tumor), abdominal discomfort, rarely hematuria or signs of hemorrhagic shock caused by spontaneous rupture of the tumor, with retroperitoneal bleeding (2,3,5,7,9,12,13,14).…”