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Adrenal Myelolipoma
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Adrenal Myelolipoma | ||
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Related narrative: Adrenal Myelolipoma Adrenal myelolipomas are benign, non-functioning tumors of the adrenal cortex. They are uncommon, with a less than 1% incidence at autopsy. There is an equal male to female ratio and they are most commonly seen in individuals over 40. The most common presentation is an incidental adrenal mass. Myelolipomas are composed of mature adipose tissue with hematopoietic elements. The etiology is unknown, but theories include metaplasia of adrenal cortical or stromal cells under hormonal influence, emboli from bone marrow, or embryonic rests of hematapoietic tissue. These tumors have been found concurrently with other endocrinological disorders such as Cushing's syndrome, Conn's syndrome, Addison's disease, or congenital adrenal hyperplasia. Symptoms from myelolipomas are usually related to mass effect or intratumoral hemorrhage. Hematuria, flank pain, palpable abdominal mass or hypertension may also be present. Myelolipomas are slow growing, usually not exceeding 5 cm in size. There have been giant forms reported with weights over 5 1/2 kilos. The treatment for larger (>4cm), symptomatic or rapidly growing tumors is surgery, which is usually curative. Smaller tumors may be observed with intermittent CT scans and biochemical analysis. There may be a role for fine needle aspiration (FNA) if the diagnosis is uncertain. The presence of megacaryocytes is the most important diagnostic feature, permitting the exclusion of malignancy. References:
Imaging and pathologic features of myelolipoma.
Myelolipoma: CT and pathologic features.
The natural history and treatment of adrenal myelolipoma.
Bilateral adrenal myelolipoma.
Bilateral symptomatic adrenal myelolipoma.
Fine-needle aspiration cytology of adrenal myelolipoma: case report and review of the literature.
Retroperitoneal hemorrhage due to a ruptured adrenal myelolipoma. A case report.
Giant adrenal myelolipoma: case report and review of the literature.
Giant myelolipoma of the adrenal gland: natural history.
Adrenal myelolipoma associated with endocrine dysfunction: review of the literature.
Symptomatic adrenal myelolipoma. Clinicopathological analysis of 7 cases and brief review of the literature.
The incidental nonhyperfunctioning adrenal mass: an imaging algorithm for characterization.
Incidentally discovered adrenal mass (incidentaloma): investigation and management of 208 patients.
Evaluation of hormonal function in a series of incidentally discovered adrenal masses.
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