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Case Report
A case of adrenal myelolipoma: A rare encounter requiring specific approach in diagnosis and management
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
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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 - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Sundus Hussein - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Samer Abou-Deeb - Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors 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.
