Adrenal Myelolipoma with Adrenocortical Adenoma Presenting with Hypertension Only

Here, we present a case of a 25-year Chinese female who was diagnosed with non-functional adrenocortical adenoma containing myelolipoma with hypertension as the only symptom. Serum levels of cortisol, aldosterone, angiotensin I/II and renin activity were normal. Myelolipoma is a benign, non-functioning retroperitoneal tumour occurring predominantly in the adrenal gland and relatively uncommon. With the advancement of radiological studies, the incidental detection of myelolipoma has been noted. However, the coexistence of adrenal myelolipoma and adrenal adenoma still remains extremely rare. Though usually benign, the later may present with endocrine dysfunction, such as Cushing's syndrome, and requires proper management. Surgical resection is reserved for symptomatic tumours or large myelolipoma (>7 cm in size). The final diagnosis mainly relies on pathological examination. The left adrenal mass was completely removed via retroperitoneal laparoscopic approach. Postoperative recovery was uneventful and her blood pressure (BP) readings were normal. At 15 months follow-up, the patient was normotensive and there was no recurrence of tumour.