FNA diagnosis of adrenal myelolipoma: A rare entity

Adrenal myelolipoma is a rare, nonfunctioning, and benign tumor. We report our experience of surgically treated patients from a single institute and review the literature. Six patients (three men and three women) were diagnosed and received surgical intervention. A retrospective analysis was done by reviewing medical records. In our series, three patients were diagnosed incidentally and the others were discovered due to symptoms. All received surgery, including laparoscopic adrenalectomy. There was no recurrence. In the literature review, right adrenal gland was dominant and the prevalent age was from the fourth to sixth decades. The most common symptoms were abdominal and flank pain. Adrenal myelolipoma is uncommon and easily confused with malignancy when of large size (≥ 6 cm). Surgery may be reserved for symptomatic cases and those lesions that cannot reliably be diagnosed. Large tumors (≥ 6 cm) can be excised surgically or laparoscopically.

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“…This is similar to autopsy results with a male-tofemale ratio of 1.75:1[1]. Most cases were diagnosed at between 40 and 69 years of age(Fig.…”

supporting

confidence: 90%

“…The incidence of adrenal myelolipoma at autopsy varies between 0.08% and 0.2% [1]. The etiology of adrenal myelolipoma is uncertain.…”

Section: Discussionmentioning

confidence: 99%

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Adrenal myelolipoma: A 10‐year single‐center experience and literature review

Hsu

Shu

Lee

et al. 2012

The Kaohsiung J of Med Scie

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“…Pre-operative diagnosis could be obtained by fine needle aspiration. The presence of cells of myeloid series with interspersed adipocytes in fine needle aspiration could make a tentative diagnosis of myelolipoma (Settakorn et al 1999, Hasan et al 2008.…”

Section: Myelolipomamentioning

confidence: 99%

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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“…1,2 These are thought to arise from metaplasia of undifferentiated stromal cells in response to stress, infection, necrosis or excessive ACTH stimulation. 3 Although majority of giant myelolipomas are symptomatic but in this era of diagnostic imaging are usually diagnosed incidentally in asymptomatic patients.…”

Section: Introductionmentioning

confidence: 99%