Giant hemorrhagic myelolipoma in a patient with sickle cell disease

Gamss, Caryn; Chia, F.K.; Chernyak, Victoria; Rozenblit, Alla M.

doi:10.1007/s10140-008-0740-3

Cited by 9 publications

(6 citation statements)

References 8 publications

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“…[ 18 19 ] Acute abdomen due to vasoocclusive crisis in AML has been reported in a case of sickle cell disease. [ 20 ] Malignant degeneration has not been reported in the literature.…”

Section: Resultsmentioning

confidence: 99%

“…Because the myeloid component of AML represents extramedullary erythropoiesis, hemolytic anemia is implicated in the etiology of AML. [ 20 49 50 ] There is an interesting case of AML associated with nephrotic syndrome in one of the publications[ 51 ] where the nephrotic syndrome disappeared after the resection of the tumor, which may be coincidental.…”

Section: Resultsmentioning

confidence: 99%

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Adrenal myelolipoma: Controversies in its management

Shenoy¹,

Thota²,

Shankar³

et al. 2015

Indian J Urol

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Adrenal myelolipomas (AMLs) are rare, benign neoplasms of the adrenal gland with varied clinical presentations. The rarity of these tumors precludes any case-controlled or randomized study into their management. The available literature is limited to case reports and short series from referral centers. This review is an effort to put the available literature into perspective such that clinical decision making can be done with some clarity. The PubMed and Cochrane databases were searched with key words Adrenal Myelolipoma, Adrenal Incidentaloma (AI) and Adrenal Collision Tumor (ACT). From over 1300 search results, 547 relevant publications dating from 1954 to 2014 were reviewed. Details of about 1231 AMLs in the indexed literature were analyzed. Increasing usage of imaging studies has significantly increased the discovery of AMLs. Although AMLs are benign tumors, those measuring larger than 6 cm are prone to rupture and hemorrhage. Thorough endocrine work-up may benefit a selected group of patients, especially those who are hypertensive, diabetic/pre-diabetic, young patients (<50 years) and those with bilateral AML. Regular observation is needed for AML patients who are being treated non-operatively, as many of them may require surgery during follow-up. Although the AACE/AAES guidelines for AI (2009) exclude AML from mandatory metabolic work-up for a newly discovered AI, we feel that a significant number of patients with AML would benefit from metabolic work-up. In the literature, endocrine dysfunction in AML is 7% as compared with 11% in AI. Endocrine dysfunction in AML is probably underdiagnosed.

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“…[ 18 19 ] Acute abdomen due to vasoocclusive crisis in AML has been reported in a case of sickle cell disease. [ 20 ] Malignant degeneration has not been reported in the literature.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Adrenal myelolipoma: Controversies in its management

Shenoy¹,

Thota²,

Shankar³

et al. 2015

Indian J Urol

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“…There is no documented association between hemolytic diseases and AM. However, it is possible that the hematopoietic stress in chronic anemia stimulates the metaplasia of adrenal stromal cells to myeloid tissue and results in the rapid growth of the tumor in this population (15).…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

Davari

Lee

2020

AACE Clinical Case Reports

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Objective: Adrenal myelolipoma (AM) is a benign tumor composed of mature fat cells and hemopoietic elements. Most AMs are incidental findings on imaging and clinically asymptomatic. The purpose of this case report is to describe a rare case of AM and explore its clinical manifestations, imaging features, and treatment. Methods: In this study, we report a case of a rapidly growing right AM in a patient with uncontrolled hemoglobin sickle cell disease. A 38-year-old male presented to our institution's endocrine surgery clinic for evaluation of an enlarging right adrenal mass. This mass was incidentally found during an abdominal ultrasound performed for transaminitis and thrombocytopenia. Patient was asymptomatic without any abdominal discomfort, back pain, nausea, or vomiting. Results: Patient was lost to follow up until 2018. Follow-up computed tomography scan in 2018 showed the right adrenal mass measuring 12.3 cm in greatest dimension with significant macroscopic fat. Given the imaging features, AM was the presumed diagnosis. However, with a medical history of uncontrolled sickle cell disease, extra-medullary hematopoiesis and rapidly growing liposarcoma could not be ruled out. Surgical excision was performed due to size and significant tumor growth. Diagnosis was confirmed with histopathology and revealed myelolipoma. Conclusion: Image characteristics can be helpful in diagnosis of AM; however, the appearance of this lesion on computed tomography can be similar to other adrenal gland pathologies such as liposarcoma and mass-forming extramedullary hematopoiesis. Percutaneous needle biopsy may be indicated if the diagnosis remains unclear.

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“…These adrenal lesions are also rarely associated with thalassemia and sickle cell anemia [87,88]. For reasons not yet understood, myelolipomas in patients with thalassemia are usually giant and bilateral.…”

Section: Adrenal Myelolipomamentioning

confidence: 99%

Unusual Presentations of Adrenal Masses

Kumar¹,

Singh²

2017

Clinical Management of Adrenal Tumors

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With the advancement in imaging technology and pathological evaluation, several unusual adrenal gland lesions have been identified over the years. Presently, the literature consists of case reports or small case series without a comprehensive review on these uncommon adrenal pathologies. The current chapter discusses the epidemiology, pathogenesis, pathology, imaging features and management principles of uncommonly reported infectious and neoplastic adrenal masses.

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Giant hemorrhagic myelolipoma in a patient with sickle cell disease

Cited by 9 publications

References 8 publications

Adrenal myelolipoma: Controversies in its management

Adrenal myelolipoma: Controversies in its management

A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

Unusual Presentations of Adrenal Masses

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