1. The adrenal myelolipoma: What do we really know?
Obasi Mary, Wu Bing Ling and Michael J Campbell , MD University of California, Davis Medical Center
Background
Results
Adrenal myelolipomas are uncommon, benign tumors of the adrenal glands that are not routinely evaluated for hormone production or followed by repeat imaging
It is felt that these tumors are slow growing, but may lead to retroperitoneal hemorrhage when they become large.
It is largely believed that these tumors are not capable of excess hormone production such as that seen in other adrenal tumors.
Little is know about this rare tumor with previous studies being mostly limited to case reports and small case series
We identified 150 (0.24%) patients with 155 adrenal myelolipomas found on a CT scan during our study period.
The mean patient age was 60.1 years
69 (46%) patients were women
The mean tumor diameter was 2.8 cm.
Twelve (7.7%) tumors were > 6 cm in diameter.
Sixty-eight (45%) patients had a follow-up CT.
At a mean time interval between CT scans of 4.4 years, only five (7%) tumors had increased by more than 1cm in diameter.
Seventeen (11%) patients underwent an evaluation for endocrine dysfunction.
Two patients were diagnosed with Cushing syndrome and one patient had primary aldosteronism.
All three hormonally active tumors were >3.5cm in size.
Adrenal Myelolipomas on Computed Tomography
150 Patients
Underwent Evaluation for Endocrine Function
17 patients
Endocrine Disorders Found
1 Primary Aldosteronism
2 Cushings Syndrome 1
Clinical Question
What is the natural history of adrenal myelolipomas?
Methods and Materials
Review of computed tomography (CT) reports of patients at a tertiary referral center between
All reports were searched for the term “myelolipoma”
Data collection via the electronic medical record
Patient characteristics
Past medical history
Evidence of endocrine dysfunction
Hemorrhagic event from the adrenal myelolipoma
Conclusions
Majority of adrenal myelolipomas are <3cm and slow growing
Patients with adrenal myelolipomas have many clinical features of Cushing syndrome and primary aldosteronism, but frequently do not undergo an evaluation for these conditions
The rate of endocrine dysfunction associated with adrenal myelolipomas may be underreported
62, 279 CT reports
Search for the term “myelolipoma”
155 adrenal myelolipomas included in study
Review of CT to confirm tumor > 1 cm
References
Yang, Yu, and Lin-Yang Ye. "Two Case Reports of Bilateral Adrenal Myelolipomas." World Journal of Clinical Cases 3.9 (2015): PubMed. 16 Sept Web. 07 Feb
"Adrenal myelolipoma." Adrenal myelolipoma. UpToDate, n.d. Web. 01 Feb
*HTN: Hypertension