Advertisement

Journal of Zhejiang University SCIENCE B

, Volume 9, Issue 6, pp 500–505 | Cite as

Adrenal myelolipoma within myxoid cortical adenoma associated with Conn’s syndrome

  • Lu Hong-sheng
  • Gan Mei-fu
  • Chen Han-song
  • Huang Shan-qiang
Case Report

Abstract

The coexistence of myelolipoma within adrenal cortical adenoma is extremely rare, for both tumors present usually as separate entities. There are only 16 such cases reported worldwide. To the best of our knowledge, the case we reported here is the first one of myxoid adrenal cortical adenoma associated with myelolipoma reported. A 32-year-old Chinese woman with 4-year history of hypertension was presented in our study. Computed tomography (CT) of the abdomen showed a large heterogeneously-enhancing mass (4.5 cm in diameter) in the left suprarenal region. Clinical history and laboratory results suggest a metabolic disorder as Conn’s syndrome. The patient underwent a left adrenalectomy, and a histopathological study confirmed the mass to be a myxoid adrenal cortical adenoma containing myelolipoma. The patient was postoperatively well and discharged uneventfully. In the present case report, we also discuss the etiology of simultaneous myelolipoma and adrenal adenoma associated with Conn’s syndrome, and the methods of the diagnosis and differential diagnosis.

Key words

Adrenal gland Myxoid adrenal cortical adenoma Myelolipoma Conn’s syndrome Pathology Immunohistochemistry 

CLC number

R73 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ammoury, R.F., heptulla, R.A., Tatevian, N., Elenberg, E., 2006. Laparscopic adrenalectomy of an adrenal adenoma with myelolipoma relieves severe hypertension in a 16-year-old patient. Pediatr. Nephrol., 21(3):433–436. [doi:10.1007/s00467-005-2114-3]PubMedCrossRefGoogle Scholar
  2. Armand, R., Cappola, A.R., Horenstein, R.B., 2004. Adrenal cortical adenoma with excess black pigment deposition, combined with myelolipoma and clinical Cushing’s syndrome. Int. J. Surg. Pathol., 12(1):57–61. [doi:10.1177/106689690401200111]PubMedCrossRefGoogle Scholar
  3. Cho, T., kitazono, S., Tanimura, A., Itoh, Y., 1984. Cortical adenoma of the adrenal gland assiciated with multiple tumors. Byorito. Risho., 21(2):101–107 (in Japanese).Google Scholar
  4. Cormio, L., Ruutu, M., Giardina, C., Selvaggi, F.P., 1992. Combined adrenal adenoma and myelolipoma in a patient with Conn’s syndrome. Case Report. Panminerva Med., 34(4):209–212.PubMedGoogle Scholar
  5. Forsthoefel, K.F., 1994. Myxoid adrenal cortical carcinoma: a case report with differential diagnostic considerations. Arch. Pathol. Lab. Med., 118(11):1151–1153.PubMedGoogle Scholar
  6. Fujita, Y., Amemiya, H., Shibuya, A., 1985. Adrenal calcification and myelolipoma associated with Cushing’s syndrome. Jikerkai Med. J., 32(9):495–501.Google Scholar
  7. Han, M., Burnett, A.L., Fishman, E.K., Marshall, F.F., 1997. The natural history and treatment of adrenal myelolipoma. J. Urol., 157(4):1213–1216. [doi:10.1016/S0022-5347(01)64926-7]PubMedCrossRefGoogle Scholar
  8. Hisamatsu, H., Sakai, H., Tsuda, S., Shigematsu, K., Kanetake, H., 2004. Combined adrenal adenoma and myelolipoma in a patient with Cushing’s syndrome: case report and review of the literature. Int. J. Urol., 11(6):416–418. [doi:10.1111/j.1442-2042.2004.00815.x]PubMedCrossRefGoogle Scholar
  9. Honda, K., Kashima, K., Daa, T., Gamachi, A., Nakayama, L., Yokoyama, S., 2001. Myxoid adrenal cortical adenoma. Pathology International, 51(11):887–891. [doi:10.1046/j.1440-1827.2001.01287.x]PubMedCrossRefGoogle Scholar
  10. Ide, H., Terado, Y., Nakagawa, T., Saito, K., Kamiyama, Y., Muto, S., Okada, H., Imamura, T., Horic, S., 2007. Incidentally discovered adrenal myelolipoma associated with hyperthyroidism. Int. J. Clin. Oncol., 12(5):379–381. [doi:10.1007/s10147-007-0662-1]PubMedCrossRefGoogle Scholar
  11. Jiang, H.F., Huang, X.H., 2002. Myelolipomatous nodules within a myxoid adrenal cortical adenoma. J. Clin. Exp. Pathol., 18(4):449–450 (in Chinese).Google Scholar
  12. Manassero, F., Pomara, G., Rappa, F., Cuttano, M.G., Crisci, A., Selli, C., 2004. Adrenal myelolipoma associated with adenoma. Int. J. Urol., 11(5):326–328. [doi:10.1111/j.1442-2042.2004.00793.x]PubMedCrossRefGoogle Scholar
  13. Matsuda, T., Abe, H., Takase, M., Arakawa, A., Matsumoto, T., Fujime, M., Suda, K., 2004. Case of combined adrenal cortical adenoma and myelolipoma. Pathology International, 54(9):725–729. [doi:10.1111/j.1440-1827.2004.01686.x]PubMedCrossRefGoogle Scholar
  14. Miyake, O., Hara, T., Matsumiya, K., Oka, T., Takaha, M., Kurata, A., 1992. Adrenal myelolipoma associated with Cushing’s syndrome: a case report. Hinyokika Kiyo, 38(6):681–684 (in Japanese).PubMedGoogle Scholar
  15. Murayama, H., Kikuchi, M., Imai, T., 1979. Myelolipoma in adenoma of accessory adrenal gland. Pathol. Res. Pract., 164(2):207–213.PubMedGoogle Scholar
  16. Olsson, C.A., Krane, R.J., Klugo, R.C., Selikowitz, S.M., 1973. Adrenal myelolopoma. Surgery, 73(8):665–670.PubMedGoogle Scholar
  17. Ong, K., Tan, K.B., Putti, T.C., 2007. Myelolipoma within a non-functional adrenal cortical adenoma. Singapore Med. J., 48(7):200–202.Google Scholar
  18. Saito, Y., Hayasaka, K., Kikuchi, Y., Amous, K., Miyata, M., 1988. A case of comined adrenal myelolipoma and adenoma. Rinshogazo, 4(1):88–92 (in Japanese).Google Scholar
  19. Vrezas, I., Wentworth, P., Bornstein, S.R., 2003. Myelolipomatous foci in an adrenal adenoma causing Cushing’s syndrome? Endocr. Res., 29(1):67–71. [doi:10.1081/ERC-120018677]PubMedCrossRefGoogle Scholar
  20. Vyberg, M., Sestoft, L., 1986. Combined adrenal myelolipoma and adenoma associated with Cushing’s syndrome. Am. J. Clin. Pathol., 86(4):541–545.PubMedGoogle Scholar
  21. Yamada, T., Ishibashi, T., Saito, H., Majima, K., Tsuda, M., Takahashi, S., Moriya, T., 2002. Non-functioning adrenocortical adenomas containing fat components. Clin. Radiol., 57(11):1034–1037. [doi:10.1053/crad.2002.1093]PubMedCrossRefGoogle Scholar

Copyright information

© Zhejiang University and Springer-Verlag GmbH 2008

Authors and Affiliations

  • Lu Hong-sheng
    • 1
  • Gan Mei-fu
    • 1
  • Chen Han-song
    • 1
  • Huang Shan-qiang
    • 1
  1. 1.Department of PathologyTaizhou HospitalLinhaiChina

Personalised recommendations