DOI: 10.36347/sjams.2016.v04i08.078

Pages: 3132-3138

Adrenal myelolipoma (AML) is a rare, benign neoplasm composed of mature adipose tissue with variable amount of hematopoetic element mostly occurring as unilateral adrenal masses. They are usually hormonally inactive and asymptomatic until they reach large sizes. With the routine use of cross sectional imaging, these lesions are now being discovered with increasing frequency. We hereby present 4 cases of myelolipoma involving adrenal cortex. These include cases of, 2 men and 2 women with mean age of 39.5 yrs ranging from 28 to 55 yrs. Detection of AML was ‘incidental’ in 3 patients while being investigated for non-adrenal symptoms (pain abdomen in 2 and work-up for gall stone disease in 1) and the other one was detected with AML during work-up for hypertension. All patients were obese (BMI > 27), two of which were hypertensive and one had type 2 diabetes. Imaging was suggestive of AML in all of them. After performing a comprehensive review of literature using the PubMed database containing the keyword adrenal myelolipoma. We identified 792 articles written from 1947 to 2016, most of which were reviewed in detail including the author’s own experience, whereafter we are highlighting the clinical features, salient diagnostic features and differential diagnosis of this neoplasm. Adrenal myelolipoma is not a common neoplasm and osteoid metaplasia in an adrenal myelolipoma is a rare incident. Adrenal myelolipoma may grow over time. Symptomatic tumors or more than 7cms should be removed due to increased risk of spontaneous rupture with retroperitoneal hemorrhage.