1/92. The elevated serum alkaline phosphatase--the chase that led to two endocrinopathies and one possible unifying diagnosis.A 39-year-old Chinese man with hypertension being evaluated for elevated serum alkaline phosphatase (SAP) levels was found to have an incidental right adrenal mass. The radiological features were characteristic of a large adrenal myelolipoma. This mass was resected and the diagnosis confirmed pathologically. His blood pressure normalised after removal of the myelolipoma, suggesting that the frequently observed association between myelolipomas and hypertension may not be entirely coincidental. Persistent elevation of the SAP levels and the discovery of hypercalcaemia after surgery led to further investigations which confirmed primary hyperparathyroidism due to a parathyroid adenoma. The patient's serum biochemistry normalised after removal of the adenoma. The association of adrenal myelolipoma with primary hyperparathyroidism has been reported in the literature only once previously. Although unconfirmed by genetic studies this association may possibly represent an unusual variation of the multiple endocrine neoplasia type 1 syndrome.- - - - - - - - - - ranking = 1keywords = adrenal (Clic here for more details about this article) |
2/92. Fine needle aspiration diagnosis of extraadrenal myelolipoma presenting as a pleural mass. A case report.BACKGROUND: myelolipoma is a benign tumor composed of mature adipose tissue and hematopoietic cells. Although they are commonly found in adrenal glands, extraadrenal myelolipomas (EMLs) are rare but well documented. They have been found in various sites, including mediastinum, liver, stomach, lungs, pelvis, spleen, retroperitoneum, presacral region and mesentery. EMLs must be distinguished from extramedullary hematopoieses, which are also composed of hematopoietic elements but may lack adipose tissue and are associated with anemia and marked bone marrow hyperplasia. CASE: We describe a case of a pleura-based, extraadrenal myelolipoma in a 53-year-old female with unremarkable bone marrow findings that were initially encountered on fluoroscopy-guided fine needle aspiration (FNA). One year later the mass was removed via open thoracotomy. It showed typical EML features histologically. CONCLUSION: EML manifests on aspiration cytology as a cellular specimen with numerous trilineage hematopoietic cells and a variable proportion of mature adipose cells. To our knowledge, FNA cytology of EML has not been found in this location before. Aspiration biopsy offers a simple and reliable method for the diagnosis of EML in the presence of appropriate clinical settings.- - - - - - - - - - ranking = 2.3333333333333keywords = adrenal (Clic here for more details about this article) |
3/92. myelolipoma of the renal sinus. An unusual site for a rare extra- adrenal lesion.Extra-adrenal myelolipomas are rare; approximately 36 cases have been reported to date. We document a case of myelolipoma presenting as a localized mass in the renal sinus of a 66-year-old man. The chief clinical and radiologic differential diagnostic considerations in this case included a malignant renal tumor arising in the hilum. The patient was being investigated for recurrent urinary tract infections and vague abdominal pains. Histologically, the lesion showed features characteristic of a myelolipoma. There was also marked chronic inflammation in and around the mass. The uneventful follow-up of 62 months is in keeping with the benign nature of this lesion. This report expands the possibilities of the differential diagnoses of renal hilar neoplasms, particularly in view of the increased use of imaging techniques that are bound to detect many incidental lesions in this region.- - - - - - - - - - ranking = 1.6666666666667keywords = adrenal (Clic here for more details about this article) |
4/92. Bilateral symptomatic adrenal myelolipoma.Myelolipomas of the adrenal gland were first described in 1905. They are rare cortical, nonfunctioning, benign neoplasms, generally unilateral, usually discovered by accident or at autopsy. Thus they are often classified as 'incidentaloma'. These tumors are more frequent in males 40-60 years old. Most adrenal myelolipomas are small (diameter < 4 cm) and asymptomatic (70%), but larger tumors may cause local symptoms secondary to mechanical compression. Very large bilateral adrenal myelolipomas are exceedingly rare. They generally require no treatment; however, if symptomatics or if diagnosis is in doubt, surgery is needed. Usually only monolateral adrenalectomy is performed, even in the presence of bilateral tumors, to preserve adrenal function. We present a case of bilateral, symptomatic giant myelolipoma in a young woman, treated with bilateral adrenalectomy.- - - - - - - - - - ranking = 3.3333333333333keywords = adrenal (Clic here for more details about this article) |
5/92. A case of lung myelolipomatosis in a patient with bronchial carcinoid.Myelolipomas are very rare benign tumours composed of an admixture of mature adipose tissue and normal haematopoietic cells. Although they are most commonly found in the adrenal glands, extra-adrenal myelolipomas are documented. We described a case of myelolipoma arising in the lung in a 52-year-old man. The lesion was found incidentally in association with a carcinoid. To our knowledge, this is the second instance of this neoplasm presenting as a lung lesion, and the first case associated with bronchial carcinoid. Pathogenesis and aetiology of myelolipomas are referred to in this paper with special regard to the clinical and pathological findings.- - - - - - - - - - ranking = 0.66666666666667keywords = adrenal (Clic here for more details about this article) |
6/92. Bilateral adrenal myelolipoma.Myelolipomas are rare benign tumors often found incidentally due, in the majority of cases, to the fact that they are asymptomatic. The incidence of adrenal myelolipomas at autopsy is low (0.2%). These tumors are made up of fat and hematopoietic cells. Their origin is unclear and different theories have been put forward, including development from rests of mesenchymal stem cells, embolism of bone marrow, extramedullary hematopoiesis and, according to the most widely accepted theory, metaplasia of the reticuloendothelial cells of blood capillaries. Due to their uncertain etiology and low frequency, management of adrenal myelolipomas is usually individualized and carried out depending on the protocols of each center. The development of improved imaging techniques has increased their diagnosis in routine clinical practice. Thus, they have been included in the heterogeneous group of 'incidentalomas' of the adrenal gland.- - - - - - - - - - ranking = 2.3333333333333keywords = adrenal (Clic here for more details about this article) |
7/92. Fine-needle aspiration cytology of adrenal myelolipoma: case report and review of the literature.Adrenal myelolipoma is a rare nonfunctioning tumor consisting histologically of an admixture of adipose tissue and extramedullary hemopoietic elements within the adrenal glands. Less than 300 cases have been reported in the literature and only 15 case reports have described cytological findings of this tumor obtained by fine-needle aspiration (FNA). We report a case of a 48-year-old male who had had anaplastic large cell carcinoma of the right lung. The left adrenal mass was encountered during a staging workup that led to a clinical suspicion of metastatic disease to the adrenal gland. FNA under computed tomography (CT) guidance was performed obtaining cytological material from which diagnosis of myelolipoma was made. The findings reemphasized an important role of FNA in investigation of adrenal mass. The literature on FNA cytology of adrenal myelolipoma is reviewed. Diagn. Cytopathol. 1999;21:409-412.- - - - - - - - - - ranking = 3keywords = adrenal (Clic here for more details about this article) |
8/92. Retroperitoneal hemorrhage due to spontaneous rupture of adrenal myelolipoma.BACKGROUND: A very rare case of retroperitoneal bleeding due to spontaneous rupture of a large adrenal myelolipoma in a 62-year-old woman is reported. methods/RESULTS: She consulted the emergency room of the Nagano red cross Hospital with a complaint of sudden left flank pain. A computerized tomography (CT) scan revealed a tumor with areas of fat density and hematoma in the left retroperitoneal space. After her general condition improved, an operation was performed. The tumor strongly adhered to the left kidney and a left nephrectomy with the tumor was curative. Histologic diagnosis was adrenal myelolipoma. No blood transfusion was required. CONCLUSIONS: A CT scan is very useful in the pre-operative diagnosis of adrenal myelolipoma with retroperitoneal hemorrhage. Watch and wait treatments before operation and nephrectomy with adhered tumor are safe and curative.- - - - - - - - - - ranking = 2.3333333333333keywords = adrenal (Clic here for more details about this article) |
9/92. Bilateral giant adrenal myelolipoma and polycystic ovarian disease.We report a case of a nonfunctioning, synchronous, bilateral, very large adrenal myelolipoma in an obese woman. She had diabetes mellitus and oligomenorrhea due to polycystic ovarian disease, and for that, she was taking progesterone medication for over 12 years. The principal clinical findings, the etiology and pathogenesis, the diagnostic-tools including US-guided fine-needle biopsy to preoperative differential diagnosis, are discussed. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 1.6666666666667keywords = adrenal (Clic here for more details about this article) |
10/92. Clinics in diagnostic imaging (43). Right adrenal myelolipoma.A 53-year-old woman who presented with drug-induced jaundice and urinary tract infection was incidentally found to have a large abdominal mass. Radiographs and ultrasonography showed a large fatty mass located between the right lobe of the liver and the right kidney. diagnosis of right adrenal myelolipoma was made on computed tomography. The patient was treated conservatively. The causes of large fatty masses of the abdomen in adults are discussed, with emphasis on the imaging appearances of myelolipoma, renal angiomyolipoma, cystic teratoma and liposarcoma.- - - - - - - - - - ranking = 1.6666666666667keywords = adrenal (Clic here for more details about this article) |
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