Adrenal myelolipoma, review of the literature in Mexico apropos of two cases
Main Article Content
Keywords
Adrenal Neoplasms, Extramedullary, Adrenal Glands, Hematopoiesis, Myelolipoma
Abstract
Background: Adrenal myelolipomas (ML) are rare benign neoplasms compound of adipose and myeloid tissue. Clinically they are usually asymptomatic, being diagnosed generally by incident. In Mexico, there are only 32 published cases of ML, these occur between 37 and 65 years, with the male-female ratio being 1:1.1, clinically they present with abdominal or lumbar pain, open surgery being the main surgical approach (89%).
Clinical case: We made a literature review of ML in Mexico and present two clinical cases: a 67-year-old man in followup for diverticular disease and a 40-year-old woman with pain in the left upper quadrant. In both cases, tumor resection was performed measuring 9.5 cm and 13.3 cm long respectively.
Conclusions: We present two new cases in our country that correspond to incidentalomas. In both cases, surgery was performed to confirm the diagnosis, as well as to prevent possible complications.
References
Decmann Á, Perge P, Tóth M, Igaz P. Adrenal myelolipoma: a comprehensive review. Endocrine. 2018;59(1):7-15. doi: 10.1007/s12020-017-1473-4.
Adapa S, Naramala S, Gayam V, Gavini F, Dhingra H, Gray-Hazard FK, et al. Adrenal Incidentaloma: Challenges in Diagnosing Adrenal Myelolipoma. J Investig Med High Impact Case Rep. 2019;7:2324709619870311. doi: 10.1177/2324709619870311.
Anis-Ul-Islam M, Qureshi AH, Zaidi SZ. Adrenal myelolipoma in a young male - a rare case scenario. J Pak Med Assoc. 2016;66(3):342-4.
Andrada M, Signorini FJ, Alcaraz Á, Giordano EA, Obeide LR. Mielolipoma retroperitoneal perirrenal. Cir Cir. 2020;88(Suppl 2): 52-55. doi: 10.24875/CIRU.20000261.
Martínez-Cornelio A, Hernández-Toriz N, Alvarado-Cabrero, et al. Mielolipoma suprarrenal, revisión de casos en México. Rev Mex Urol. 2008;68(6):334-40.
Vigutto G, Lauro A, Vaccari S, Pirini MG, Diegoli M, D’Andrea V, et. al. Giant Retroperitoneal Myelolipoma: An Unusual Diagnostic GI Challenge - Case Report and Review of the Literature. Dig. Dis. Sci. 2019;64(12):3431-5. doi: 10.1007/ s10620-019-05897-9.
Carranza-Lira S, Luisa-Jiménez A, Quiroz E, Kofman-Alfaro S, Zenteno JC. 46 XY Agonadism mass associated with adrenal adenoma/myelolipoma: Report of a case analyzing Y-chromosome-specific sequences. Gynecol Endocrinol. 2003;17(5):429-32. doi: 10.1080/09513590312331290348.
Bautista-Olayo R, San-Cristobal ZP, Guzman-Gutierrez M, Diliz-Pérez HS, Garcia AR. Incidentalomas adrenales: a propósito de un mielolipoma. Cir Gen. 2014;36(4):239-44. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_ arttext&pid=S1405-00992014000400239#:~:text=Las%20 lesiones%20adrenales%20diagnosticadas%2incidentalmente ,vecinas%2C%20son%20altamente%20sospechosos%20de.
Hamidi O, Raman R, Lazik N, Iniguez-Ariza N, McKenzie TJ, Lyden ML. et al. Clinical course of adrenal myelolipoma: A long-term longitudinal follow-up study. Clin Endocrinol (Oxf). 2020;93(1):11–18. doi: 10.1111/cen.14188.
Campbell MJ, Obasi M, Wu B, Corwin MT, Fananapazir G. The radiographically diagnosed adrenal myelolipoma: what do we really know? Endocrine. 2017;58(2):289-94. doi: 10.1007/ s12020-017-1410-6.
Littrell LA, Carter JM, Broski SM, Wenger DE. Extra-adrenalmyelolipoma and extra medullary hematopoiesis: Imaging features of two similar benign fat-containing presacral masses that may mimic liposarcoma. Eur Radiol Exp. 2017;93: 185-94. doi: 10.1016/j.ejrad.2017.05.039.
Westcott GP, Sadeghi-Nejad A, Munoz-Pena J, Blau A, Goodman M, Siegel RD. Gender Reversal and Bilateral Giant Adrenal Myelolipomas in a 46XX patient with 21-Hydroxylase deficiency: Case Report and Review of the Literature. AACE Clinical Case Reports. 2017;3(3):217-24. doi: 10.4158/ EP161343.CR.
Cantellano-Orozco M, Merayo-Chalico C, Shuck-Bello C, Saavedra-Briones D, Camarena-Reynoso H, Vázquez-Ortega L, et al. Surgical pathology of the adrenal gland: cases managed at the Dr. Manuel Gea González General Hospital over a period of 20 years. Rev Mex Urol. 2009;69(5):238-242.
Campos-Campos SF, Lara-Olmedo JL, Cervantes-Cruz J. Adrenalectomía laparoscópica. Experiencia con abordaje antero-lateral transperitoneal. Cir Gen. 2009;31(2):73-80.
Zuviri-González A, Espinosa-Pérez DA, Guzmán-Hernández F, Catalán-Quinto G, Mateos-Chavolla JP, Hernández-Beltrán MA, et al. Mielolipoma supradrenal. Rev Mex Urol. 2011; 71(3):188-191.
Nuño-Guzmán CM, Arróniz-Jáuregui J, Espejo I, ValleGonzález J, Butus H, Molina-Romo A, et al. Left hepatic lobe herniation through an incisional anterior abdominal wall hernia and right adrenal myelolipoma: a case report and re-view of the literature. J Med Case Reports. 2012;6(1):1-5. doi: 10.1186/1752-1947-6-4.
Garduño-García JJ, Arjona-Villicana R, Pimentel L, Perez-Diaz I, Gomez-Perez F. Mielolipoma adrenal gigante de aparición tardía en una paciente con hiperplasia adrenal congénita. Endocrinol Nutr. 2013;60(9). doi: 10.1016/j.endoen.2013.11.002.
Gutiérrez JD, Palacios JM, Martínez GM, Brambila EA. Adrenalectomía laparoscópica y lumboscópica. Siete años de experiencia en un hospital de tercer nivel. Bol Col Mex Urol. 2013;28:54-59.
Padilla-Pina J, García-Vásquez RA, Arriaga-Aguilar J, VegaCastro R, Pérez-Manzanares VM, et al. Tumor renal izquierdo y tumor suprarrenal derecho: abordaje laparoscópico en el mismo tiempo quirúrgico. Rev Mex Urol. 2015;75(3):154-157. doi: 10.48193/rmu.v75i3.260.
Luna-Vicencio A, Guerrero-Avendaño G. Pediatric suprarenal myelolipoma as simulator of Wilms’ tumor. An Radiol Méx. 2015;14(4):389-394.
Pineda-Murillo J, Vergara-Vizuet J, Hernández-León O, Torres-Aguilar J, Vivero Contreras C, Marín-Guizar DM. Tratamiento laparoscópico transperitoneal de mielolipoma suprarrenal. Rev Mex Urol. 2017;77(3):213-218.
Nava-Carmona O, Medina-Andrade LA, Rocha-Erazo OR, Cano-Rodriguez MD, Flores-Galicia HV, Samaniego-Martinez, et al. A Very Rare Adrenal Tumor: Myelolipoma, Case Report. ARC Journal of Surgery. 2017;3(1):5-7.
Article Sidebar
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain their copyright and grant the Revista Médica del IMSS the right of first publication. Articles are distributed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which allows sharing as long as the author and the original source are properly credited.