Central serous chorioretinopathy associated with adrenal myelolipoma

We describe a case of central serous chorioretinopathy associated with a large adrenal myelolipoma.

A 55-year old man was admitted to our clinic complaining for metamorphopsia and blurred vision in his left eye. Standard ophthalmologic examination and fluorescein angiography established the diagnosis of central serous chorioretinopathy (CSC). Due to the presence of arterial hypertension, we proceeded to a thorough systemic clinical and laboratory investigation.

Clinical and laboratory investigation disclosed a large mass in the right abdominal region. Magnetic resonance imaging showed that this mass was located superior to the right kidney, in the right adrenal gland, compressing the kidney and the liver. Surgical excision of the mass was done one month later. Histological examination revealed an adrenal myelolipoma. Improvement of CSC was recorded one month after surgery with complete remission two months later. Additionally, systemic blood pressure and increased urinary steroids concentration before the operation returned to normal in the late postoperative period.

CSC pathogenesis is not well understood. Many factors are implicated in this disease. Hypercortisolism and sympathetic activity play a crucial role in the pathogenesis of CSC. This is the first report of CSC in a patient with a benign tumor of the adrenal gland without Cushing's syndrome.