Myelolipoma: a rare incidentally detected adrenal lesion

Abstract

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.