Myelolipoma, an infrequent surgical lesion of the adrenal gland

Abstract

Myelolipoma is a non functioning benign tumor of the adrenal gland which is formed by hematopoietic and adipose tissue. The tumor was first described by Gierke in 1905, and named by Oberling in 1929. Most series consist of myelolipomas discovered incidentally at autopsy. They are generally located in the adrenal gland, although they can occur in other organs. Endocrine and/or metabolic disorders associated with AML include obesity, Type II Diabetes, congenital adrenal hyperplasia due to 21 or 17 alpha-hydroxylase deficiency, Cushing's disease, Conn's syndrome, pheochromocytoma and polycystic ovarian disease.

Myelolipomas are asymptomatic, but they may cause pain secondary to bleeding, hematuria or mass; when symptomatic, the most consistent complaint is abdominal pain caused by hemorrhage within the tumor. Ultrasound combined with computed tomography is useful in diagnosis. Definitive diagnosis and treatment are accomplished by simple excision and histological report; radical surgery is unnecessary.

We present here the case of a 55 years old female who came in with abdominal pain, nausea and vomiting. After an abdominal ultrasound, an abdominal CT scan and eventually, surgical removal, an adrenal myelolipoma was found. She did well after surgery and remains asymptomatic.