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Adrenal Myelolipoma



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.


Imaging and pathologic features of myelolipoma.
Rao P - Radiographics - 1997 Nov-Dec; 17(6): 1373-85

Myelolipoma: CT and pathologic features.
Kenney PJ - Radiology - 1998 Jul; 208(1): 87-95

The natural history and treatment of adrenal myelolipoma.
Han M - J Urol - 1997 Apr; 157(4): 1213-6

Bilateral adrenal myelolipoma.
Segura Martin M - Urol Int - 1999; 62(4): 226-8

Bilateral symptomatic adrenal myelolipoma.
Appetecchia M - Urol Int - 1999; 62(1): 37-9

Fine-needle aspiration cytology of adrenal myelolipoma: case report and review of the literature.
Settakorn J - Diagn Cytopathol - 1999 Dec; 21(6): 409-12

Retroperitoneal hemorrhage due to a ruptured adrenal myelolipoma. A case report.
Catalano O - Acta Radiol - 1996 Sep; 37(5): 688-90

Giant adrenal myelolipoma: case report and review of the literature.
Yildiz L - Pathol Int - 2000 Jun; 50(6): 502-4

Giant myelolipoma of the adrenal gland: natural history.
Hoeffel CC - Clin Radiol - 2000 May; 55(5): 402-4

Adrenal myelolipoma associated with endocrine dysfunction: review of the literature.
Umpierrez MB - Am J Med Sci - 1997 Nov; 314(5): 338-41

Symptomatic adrenal myelolipoma. Clinicopathological analysis of 7 cases and brief review of the literature.
Sharma MC - Urol Int - 1997; 59(2): 119-24

The incidental nonhyperfunctioning adrenal mass: an imaging algorithm for characterization.
Pender SM - Clin Radiol - 1998 Nov; 53(11): 796-804

Incidentally discovered adrenal mass (incidentaloma): investigation and management of 208 patients.
Kasperlik-Zeluska AA - Clin Endocrinol (Oxf) - 1997 Jan; 46(1): 29-37

Evaluation of hormonal function in a series of incidentally discovered adrenal masses.
Bondanelli M - Metabolism - 1997 Jan; 46(1): 107-13

This page was last modified on 17-Jan-2001.