Related Experiment Videos
Bilateral giant adrenal myelolipomas: a case report
William R Wrightson1, Thomas X Hahm, Julie R Hutchinson
1Department of Surgery, University of Louisville, Kentucky 40293, USA.
The American Surgeon
|June 25, 2002
Summary
Giant adrenal myelolipomas, though rare and typically benign, can cause significant symptoms. Surgical excision is recommended for symptomatic cases to relieve pain and preserve adrenal function.
Area of Science:
- Endocrinology
- Surgical Oncology
- Pathology
Background:
- Myelolipomas are rare, benign tumors of fatty tissue and bone marrow elements.
- Adrenal myelolipomas are usually asymptomatic, nonfunctioning, and discovered incidentally, typically measuring less than 5 cm.
- While often associated with endocrine disorders, they can occur as solitary masses.
Observation:
- A 54-year-old man presented with abdominal pain and shoulder pain due to bilateral giant adrenal myelolipomas (12x14 cm and 8x10 cm).
- Imaging revealed suprarenal masses consistent with fatty tissue and a separate 5x4 cm mass in the transverse colon.
- Due to symptoms and the inability to rule out liposarcoma, exploratory laparotomy with mass excision and colectomy was performed.
Findings:
- Histologic analysis confirmed bilateral adrenal myelolipomas and a benign lipoma of the transverse colon.
- The patient's postoperative course was uneventful, with complete resolution of pain.
Implications:
- Symptomatic adrenal myelolipomas, even those exceeding 5 cm, warrant surgical management.
- Excision of adrenal myelolipomas is crucial for symptom relief and requires careful preservation of adrenal tissue to avoid lifelong steroid replacement therapy.