Mm. Elmekresh et al., CLINICAL, RADIOLOGICAL AND HISTOLOGICAL FEATURES OF ADRENAL MYELOLIPOMA - REVIEW AND EXPERIENCE WITH A FURTHER 8 CASES, British Journal of Urology, 78(3), 1996, pp. 345-350
Objective To review published reports of surgically treated adrenal my
elolipomas and report experience with a further eight cases. Patients
and methods Eight patients (three men and Jive women, mean age 50.7 ye
ars) with adrenal myelolipoma were treated surgically because of the t
umour size, symptomatology and/or associated renal pathology. Associat
ed medical problems included hypertension in three patients and diabet
es mellitus in one but none of the tumours was endocrinologically acti
ve. Results Five patients were diagnosed definitively by abdominal ult
rasonography, computed tomography and angiography while the other thre
e were incidentally diagnosed during surgical intervention for ipsilat
eral renal cell carcinoma in one patient, hydronephrotic kidney in ano
ther and multiple renal stones in the third, On pathological examinati
on, the masses removed were surrounded by a thin fibrous capsule and c
ompressed cortical tissue. A cut section was bright yellow with foci o
f red-brown discoloration. Microscopically, the tumour consisted mainl
y of mature adipose tissue with scattered islands of haemopoietic cell
s. There was no operative mortality and no gross morbidity. Conclusion
The management of adrenal myelolipoma should be appropriate to each i
ndividual case. Operative intervention should be reserved for symptoma
tic patients or those with large 'silent' tumours that may produce lif
e-threatening shock secondary to spontaneous haemorrhage. Small asympt
omatic tumours with definite radiological findings can be followed exp
ectantly.