Adrenal Myelolipoma: Profile of Six Patients With a Brief Review of Literature

Abstract

Six patients with adrenal myelolipoma (AML) are reported. They included 3 men and 3 women with mean age (+ SD) of 42.3 + 10.9 yrs ranging from 26 to 60 yrs. Four patients were symptomatic, while the other 2 had no symptoms. Detection of AML was ‘incidental’ in 4 patients while being investigated for non-adrenal symptoms (pain abdomen in 2 and work-up for renal disease in 2), while the remaining 2 patients, one (#5) with congenital adrenal hyperplasia due to 21 alpha-hydroxylase deficiency had myelolipomatous alterations in the adrenal gland and the other (#6) had detection of AML during work-up for hypertension. All patients were obese (BMI > 27), four were hypertensive and one had type 2 diabetes. Imaging was suggestive of AML in five of them. However, in one case radiological diagnosis of angiomyolipoma of the kidney was considered. Interestingly, the right adrenal was involved in five of them. Four patients underwent adrenalectomy in view of symptoms and size of the mass, while the other 2 are under follow-up. Cyto/histopathology was consistent with AML in all these patients. However, in one case myelolipomatous alterations were noted in the background of adreno-cortical tumor. No recurrence or alterations in tumor size was noted during the follow-up period ranging from 6 months to 4 years. A brief review of literature is also presented.