Giant adrenal myelolipoma with hemorrhage masquerading as retroperitoneal sarcoma

Abstract

Adrenal myelolipomas are functionally inactive, rare adrenal tumors which are usually small in size and are discovered incidentally. Giant symptomatic myelolipomas have rarely been reported in medical literature. Here, we describe the case of a 40-year-old female patient who presented to the surgical outpatient department with left flank pain. An ultrasonogram of the abdomen suggested a large retroperitoneal tumor which was then surgically resected. Histopathological examination of the resected specimen revealed a giant adrenal myelolipoma with intratumoral hemorrhage. The patient was relieved of symptoms and was free of any complaints in follow-up.

Keywords: Adrenal glands; giant myelolipoma; hemorrhage; sarcoma.

Figure 1

Photograph showing the gross specimen of giant adrenal myelolipoma with hemorrhage. The lipomatous component is seen in the periphery (black arrow)

Figure 2

Microphotograph showing admixture of adipose tissue with hematopoietic elements. The preserved adrenal tissue is seen in the upper part of the tumor. (Hematoxylin and eosin stain, ×100 magnification). Inset shows high power view of a megakaryocyte in a background of myeloid and erythroid cells. (Hematoxylin and eosin stain, ×400 magnification). Megakaryocytes are highlighted with black arrows