Composite Adenomatoid Tumor and Myelolipoma of Adrenal Gland: Report of 2 Cases

Abstract

Adenomatoid tumor and myelolipoma are benign, hormonally inactive tumors that are often incidental findings in the adrenal glands. Myelolipoma is more common than adenomatoid tumor in this location but both are rare, and as yet, the pathogenesis of both remains unclear. We report 2 cases of composite adenomatoid tumor and myelolipoma, incidentally found in the adrenal gland on investigation for other diseases. To our knowledge, composite adenomatoid tumor and myelolipoma of adrenal gland has not been previously reported.

Adenomatoid Tumor of the Adrenal Gland: Report of Two Cases and Review of the Literature

“…Adenomatoid tumor (AT) of the adrenal gland is extremely rare. From 1988 to 2020, only 39 cases of adrenal AT were reported in the English medical literature, among which only four authors reported more than one case of adrenal AT (6,10,14,18), and the rest was a single case report. Here we report two novel cases and review the literature to summarize the clinical, morphological, immunohistochemical, and prognostic features of adrenal AT more comprehensively than before.…”

“…Moreover, two cases of adrenal AT in a man who sought evaluation of renal colic or acute right flank pain due to nephrolithiasis were reported by Denicol et al (13) and Varkarakis et al (15), respectively. A few patients had a history of sarcoma (6), inguinal hernia (18), colon cancer (20), and mucoepidermoid carcinoma (11), and adrenal AT was incidentally discovered.…”

“…Other histological characteristics have been noted including dystrophic calcifications (6,10,(15)(16)(17)19), intratumoral adipose tissue (14,18,22) and metaplastic ossification (15). Timonera et al (18) reported two cases of composite AT and myelolipoma with unclear pathogenesis. In the non-neoplastic adrenal tissue, adrenocortical hyperplasia was found in two cases (4,11), and cytomegalovirus (CMV) infections with classical viral inclusions were seen in a patient with AIDS (7).…”

“…( 15 ), respectively. A few patients had a history of sarcoma ( 6 ), inguinal hernia ( 18 ), colon cancer ( 20 ), and mucoepidermoid carcinoma ( 11 ), and adrenal AT was incidentally discovered.…”

“…Lymphocyte infiltration and aggregates can be found in most cases which is also the histological feature of adrenal ATs. Other histological characteristics have been noted including dystrophic calcifications ( 6 , 10 , 15 – 17 , 19 ), intratumoral adipose tissue ( 14 , 18 , 22 ) and metaplastic ossification ( 15 ). Timonera et al.…”