A large adrenal myelolipoma: case report and review of the literature

Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose tissue and myeloid tissue with a variable amount of hematopoietic elements. Most patients are asymptomatic although some present with pain or even endocrine dysfunction. The rising use of CT and MRI scans has led to an increase of the detection of adrenal myelolipomas in recent years. The indications for surgery are symptomatic patients and lesions bigger than 5 cm or suspicious for malignancy. A case of a 50-year-old woman is presented here who was referred for surgical resection of a large nonfunctioning right adrenal mass. The neoplasm was resected through a midline laparotomy. Histopathology revealed a lesion consisting predominantly of fatty issue containing all types of hematopoietic stem cells and confirmed the diagnosis of myelolipoma.