Adrenal Myelolipoma Presenting as a Retroperitoneal Mass: A Case Report
DOI:
https://doi.org/10.21276/apalm.3916Keywords:
adrenal myelolipoma, adrenal neoplasms, retroperitoneal mass, adrenalectomy, histopathologyAbstract
Introduction: Adrenal myelolipoma is a rare, benign, non-functional adrenal tumor composed of mature adipose tissue and trilineage hematopoietic elements. Most cases are asymptomatic and detected incidentally during imaging for unrelated conditions. Large lesions may present with compressive symptoms or complications such as hemorrhage or rupture. The exact pathogenesis remains unclear but is hypothesized to involve metaplasia of adrenal cortical cells due to chronic stress or endocrine stimulation.
Case Presentation: A 54-year-old male with type 2 diabetes mellitus and hypertension presented with a one-year history of decreased urine stream. Imaging revealed a large, non-enhancing, fat-density mass in the right adrenal gland measuring 10.4 × 6.4 × 6.0 cm, abutting the liver and inferior vena cava. Hormonal evaluation was normal. The patient underwent right open adrenalectomy. Gross examination showed a well-encapsulated lobular mass with variegated grey-brown cut surfaces, peripheral fatty areas, and foci of hemorrhage. Histopathological examination confirmed adrenal myelolipoma, demonstrating mature adipose tissue admixed with erythroid, myeloid, and megakaryocytic precursors without atypia, necrosis, or capsular invasion.
Conclusion: This case highlights the importance of considering adrenal myelolipoma in the differential diagnosis of fat-containing adrenal masses. Surgical excision is recommended for symptomatic or large tumours. Histopathology remains the gold standard for diagnosis, exclusion of malignancy and guiding management. Prognosis is excellent with negligible recurrence risk.
References
1. Pogula VR, Galeti EH, Thakare KV, Velivela V, Reddy SV, Verma A, Galeti A. Giant adrenal myelolipoma treated by laparoscopic excision: a case report and review of literature. Annals of Urologic Oncology. 2021;62-68. https://doi.org/10.32948/auo.2021.12.29
2. Duarte Regalado CS, Guzmán Mejía JI, Gutiérrez Uvalle GE, et al. A case report and literature review of adrenal myelolipoma. Cureus. 2023 Aug 9;15(8):e43240. doi:10.7759/cureus.43240
3. Tayade S, Bondge AR, Buch A, Kumar H. Adrenal myelolipoma: a rare entity. Medical Journal of Dr. D.Y. Patil Vidyapeeth. 2020 Jan–Feb;13(1):82-84. DOI: 10.4103/mjdrdypu.mjdrdypu_109_19
4. Díaz H, Millán Flores RA, Ancona Pérez HA, Ventura Trujeque BV. Unilateral giant myelolipoma of the adrenal gland: a case report. Cureus. 2025 Jan 15;17(1):e77510.
5. Katsoulis IE, Dafnis AN, Sourouppi C, Katsaounis D, Boti E, Arnogiannaki N. A large adrenal myelolipoma: case report and review of the literature. J Surg Case Rep. 2023 Jun 7;2023(6):rjad326. doi: 10.1093/jscr/rjad326.
6. Bharati K, Singh A, Bharti R, Singh R. Adrenal myelolipoma: a series of three cases. Journal of Clinical and Diagnostic Research. 2022 Feb;16(2):ER01-ER03.
7. Benaich D, Hadj Hsain I, Jahid A, Zouaidia F, Znati K, Bernoussi Z. Adrenal myelolipoma: case report. SAS J Surg. 2024 Feb;10(2):152-156.
8. Padhy AP, Kanungo A, Das DKS. Very rare giant adrenal myelolipoma: a tumor mimic. International Journal of Surgery. 2020;7:586-588.
9. Mahadik AG, Beldar NL, Kumar M, Attarde N, Bhatnagar I. Case report of a 60-year-old male with giant adrenal myelolipoma. International Surgery Journal. 2023;10(4):786-790.
10. Nigam N, Kumari N, Mayilvaganan S. Clinicopathological analysis of adrenal myelolipoma and predicting complications based on histology: an experience from a tertiary care center. Journal of Surgery and Research. 2025;Early-Online:164-171.
11. Rahoui M, Ouanes Y, Chaker K, Dali KM, Bibi M, Sellami A, Rhouma SB, Nouira Y. Giant adrenal myelolipoma in a young female patient: a case report. Journal of Surgical Case Reports. 2022;5:1-2. http://dx.doi.org/10.1093/jscr/rjac213
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Ambiga S, Mridula Kamath, Taqiya Nuzhath, Suchithra A Shetty
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
How to Cite
