Introduction: Adrenal myelolipoma is a rare, benign, non-secreting tumor, often found incidentally or in the context of abdominal pain. We report the cases of two patients with adrenal myelolipoma hospitalized at the endocrinology department of diabetology and metabolic diseases of Ibn Rochd University Hospital in Casablanca.
Case 1: This is a 30-year-old patient, hospitalized for adrenal mass, revealed by right lower back pain, radiating to the right hypochondrium, moreover the patient presented headaches with night sweats. The clinical examination revealed a sensitivity of the right lumbar fossa. Pheochromocytoma and adrenal corticosteroids were found to be abnormal, including 24 hour urinary methoxylated derivatives and urinary free cortisolemia. Moreover, the adrenal CT showed on the right a mass of sharp contours, of fat density with tissue contingent, without signs of invasion, measuring 85×71×61 mm. The patient was operated by laparotomy, with an anatomic pathological examination of the adrenal myelolipoma.
Case 2: This is a 36 year old patient, admitted for management of left adrenal mass, revealed by lumbago, without signs of endocrionnian hypersecretion. The clinical examination was without particularities. The 24-hour methoxylated urinary derivatives and urinary free cortisolemia were without abnormalities, whereas the adrenal CT showed a mass of fat density measuring 118×92×85 mm in the left adrenal gland. The patient was operated on by laparotomy, with histopathological examination showing an appearance of adrenal myelolipoma with capsular intrusion without signs of malignancy.
Conclusion: The adrenal myelolipoma is a rare, benign tumor, often of accidental discovery, in our context revealed by lumbago. The average age of discovery is around fifty whereas in our series the patients are under 40 years old. The scanner directs the diagnosis by identifying the fat quota. Usually respected, the excision of the myelolipoma is indicated when it is bulky, compressive or presenting a risk haemorrhagic. Anatomo-pathological examination confirms the diagnosis.
18 - 21 May 2019
European Society of Endocrinology