[Bilateral synchronous adrenal myelolipomas: a case report]

Area of Science:

• Endocrinology
• Surgical Oncology
• Pathology

Background:

• Adrenal myelolipomas are rare, benign tumors composed of mature adipose and hematopoietic tissue.
• Bilateral synchronous adrenal myelolipomas are exceptionally uncommon.
• This case involves a 70-year-old male initially diagnosed with fatty liver.

Observation:

• The patient presented with incidentally discovered bilateral synchronous adrenal myelolipomas 6 years prior.
• Tumor growth was noted on computed tomographic scans, prompting surgical intervention.
• No subjective symptoms were reported by the patient despite tumor enlargement.

Findings:

• Histopathological examination confirmed the diagnosis of myelolipoma, characterized by mature adipose tissue and hematopoietic elements (myeloid, lymphoid, erythroid, megakaryocytic).
• The in vivo tumor doubling times were calculated at 16.1 months for one adrenal tumor and 31.3 months for the other.
• No cellular atypia was observed, consistent with a benign neoplastic process.

Implications:

• This case highlights the importance of long-term monitoring for incidentally discovered adrenal lesions.
• Understanding the growth kinetics of adrenal myelolipomas is crucial for clinical management decisions.
• Surgical resection is a viable option for symptomatic or growing adrenal myelolipomas, even in the absence of malignancy.