Case Report


A case of adrenal myelolipoma: A rare encounter requiring specific approach in diagnosis and management

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1 Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait

2 Department of Pathology, Mubarak Al-Kabeer Hospital, Ministry of Health, Kuwait City, Kuwait

3 IMAGES Diagnostic Center, Kuwait City, Kuwait

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Kamel El-Reshaid

Professor, Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait, P O Box 24923, 13110 Safat,

Kuwait

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Article ID: 101466Z01KE2024

doi: 10.5348/101466Z01KE2024CR

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How to cite this article

El-Reshaid K, Hussein S, Abou-Deeb S. A case of adrenal myelolipoma: A rare encounter requiring specific approach in diagnosis and management. Int J Case Rep Images 2024;15(2):34–37.

ABSTRACT


Introduction: Myelolipoma is a rare, benign and non-functional tumor that predominantly develops in the adrenal gland.

Case Report: A 71-year-old man presented with large and symptomatic myelolipoma that indicated surgery for symptomatic relieve and definite diagnosis. Hormonal testing was negative for functioning adrenal tumors. Since the patient had moderate renal failure; contrast studies were avoided. Computed tomography (CT) scan showed 6×6 cm well circumscribed left adrenal mass with adipose tissue (very low CT density) and foci of calcifications. 18F-FDG-positron-emission tomography (PET)/CT scanning showed hypermetabolic activity limited to the tumor rim. Macroscopic examination showed foci of hemorrhage, necrosis and cystic degeneration with calcifications. Microscopic examination showed mature adipose tissue admixture with an extramedullary trilinear hematopoiesis without atypia of sarcomata and smooth muscle elements akin to angiomyolipomata.

Conclusion: The diagnosis of myelolipoma requires hormonal testing, CT/magnetic resonance imaging (MRI) scans and PET study with individualized management tailored to each case.

Keywords: Adrenal, Incidentaloma, Metaplasia, Myelolipoma

SUPPORTING INFORMATION


Author Contributions

Kamel El-Reshaid - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Sundus Hussein - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Samer Abou-Deeb - Acquisition of data, Analysis of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

Source of Support

None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2024 Kamel El-Reshaid et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.