A Giant Myelolipoma of the Right Adrenal Gland: A Case Report

Gianfrancesco Intini, Fabio Melandro, Gabriela Arroyo Murillo, Francesco Giovanardi, Manuela Garofalo and Pasquale Bartolomeo Berloco

Department of General Surgery and Transplantation, Sapienza University of Rome, Italy

^*Correspondance to: Gianfrancesco Intini 

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Abstract:

Introduction: Adrenal myelolipoma is a rare nonfunctioning neoplasm of the adrenal gland, composed by hematopoietic tissue and fat cells, normally incidentalomas. Case Report: A 56-year-old man had been subjected to CT-scan and MR that showed the presence of a huge solid mass, encapsulated in the right upper quadrant with mixed content and adipose tissue. After laparotomy we found a giant mass, adherent to the liver with no signs of infiltration, including the right adrenal gland. After four hours of surgery we removed a well-capsulated 6 kilograms mass. The patient was discharged on postoperative day ten in good conditions after an uneventful course. The histological report shows an adrenal myelolipoma, constituted by cortical adrenal and fatty tissue, three lineages of hematopoietic elements and hemorrhagic areas. Discussion: Myelolipomas are correlated with abdominal pain, hemorrhage or necrosis, but are often asymptomatic; usually unilateral, they can be bilateral or extra adrenal. It is hormonally inactive but it can coexist with other hormonally active tumors of the adrenal gland and it is associated with hypertension, atherosclerosis, diabetes mellitus, and other chronic conditions. CT scan and NRM are the best diagnostic option. Surgical treatment should be recommended only in symptomatic cases or for huge masses. Conclusion: Clear diagnosis helps for exclude other condition, because surgical treatment is reserved to symptomatic cases and masses with a high risk of rupture. The treatment spectrum can be enlarged by a minimally invasive approach.

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Cite the Article:

Intini G, Melandro F, Arroyo Murillo G, Giovanardi F, Garofalo M, Bartolomeo Berloco P. A Giant Myelolipoma of the Right Adrenal Gland: A Case Report. Clin Case Rep Int. 2022; 6: 1350.