Canan FIRAT, Seda ERYİĞİT, Serkan YENER, Tevfik DEMİR, Ozan BOZKURT, Ömer DEMİR, Burçin TUNA, Kutsal YÖRÜKOĞLU

Adrenokortikal adenomda myelolipomatöz değişiklikler

Myelolipoma is a rare benign tumor which is generally detected incidentally. The tumor consists of mature fat tissue and hematopoietic cells that resemble bone marrow. The coexistence of myelolipoma and non-functional adrenocortical adenoma in the same gland is exceedingly rare. We herein present two cases of adrenal myelolipoma in association with non-functional adrenocortical adenoma in left adrenal gland of a 62-year-old woman and non-functional adrenocortical adenoma combined with myelolipoma and endothelial cyst, in right adrenal gland of a 73-years-old man. Microscopically, in the central of the tumor, there was a myelolipomatous area composed of adipocytes and hematopoietic cells surrounded by sheets of adenoma cells. The histopathological diagnosis was “myelolipomatous changes within a non-functional adrenocortical adenoma”. The cases are presented here with their rarity and pathological differential diagnosis.

Myelolipomatous changes within adrenocortical adenoma

Keywords:

Adenoma, adrenal, cortical, myelolipoma, non-functional,

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1. Lerttumnongtum P, Muttarak M, Visrutaratna P , Charin Y. Imaging features of unusual adrenal masses. Australas Radiol. 2004;48:107-13.
2. Kenney P J, Wagner BJ, Rao P, Heffess CS. Myelolipoma: CT pathologic features. Radiology. 1998;208:87-95.
3. Arm, R, Cappola AR, Horenstein RB, Drachenberg CB, Sasano H., Papadimitriou JC. Adrenal cortical adenoma with excess black pigment deposition, combined with myelolipoma, clinical Cushing's syndrome. Int J Surg Pathol. 2004;12:57-61.
4. Sun X, A Ayala, C Y Castro. Adrenocortical carcinoma with concomitant myelolipoma in a patient with hyperaldosteronism. Arch Pathol Lab Med. 2005;129:144-7.
5. Ukimura O, Inui E, Ochiai A, Kojima M , Watanabe H. Combined adrenal myelolipoma , pheochromocytoma. J Urol. 1995;154:1470.
6. Merchant S H, Herman CM, Amin MB, Ro JY, Toroncoso P. Myelolipoma associated with adrenal ganglioneuroma. Arch Pathol Lab Med. 2002;126:736-7.
7. Weiner S, Bernstein RG, Lowy S, Karp H. Case report. Combined adrenal adenoma, myelolipoma. J Comput Assist Tomogr. 1981;5:440-2.
8. Gurbuz E, Sayar H, Bakaris S, Inci MF. Adrenal myelolipoma's connection with adenoma in the same adrenal gland. BMJ Case Rep. 2013;2013:pii: bcr2013008925.
9. Ong K, K B Tan, T C Putti. Myelolipoma within a non-functional adrenal cortical adenoma. Singapore Med J. 2007;48:200-2.
10. Manassero F, Pomara G, Rappa F, Cuttano MG, Crisci A, Selli C. Adrenal myelolipom associated with adenoma. Int J Urol. 2004;11:326-8.
11. Yamada S, Tanimoto A, Wang KY, Ding Y, Guo X, Shimajiri S et al. Non-functional adrenocortical adenoma: a unique case of combination with myelolipoma, endothelial cysts. Pathol Res Pract. 2011;207(3):192-6.
12. Al-Brahim N, Asa S. Myelolipoma with adrenocortical adenoma: an unusual combination that can resemble carcinoma. Endocr Pathol. 2007;18:103-5.
13. Bisho E, Eble JN, Cheng L. Adrenal myelolipomas show nonr, om X-chromosome inactivation in hematopoietic elements, fat: support for a clonal origin of myelolipomas, Am J Surg Pathol. 2006;30:838–43.
14. Nigawara T, Sakihara S, Kageyama K, Endothelial cyst of the adrenal gland associated with adrenocortical adenoma: preoperative images simulate carcinoma, Intern Med. 2009;48:235-40.
15. 15.Goetz S P, Niemann TH, Robinson RA, Cohen MB. Hematopoietic elements associated with adrenal glands. A study of the spectrum of change in nine cases. Arch Pathol Lab Med. 1994;118:895-6.
16. Lockhart M E, J.K. Smith, P J Kenney. Imaging of adrenal masses. Eur J Radiol. 2002;41:95-112.
17. Plaut A. Myelolipoma in the adrenal cortex; myeloadipose structures. Am J Pathol. 1958; 34:487- 515.
18. Fowler M R, Williams RB, Alba JM, Byrd CR Extraadrenal myelolipomas compared with extramedullary hematopoietic tumors: a case of presacral myelolipoma. Am J Surg Pathol. 1982;6:363-74.
19. Masugi Y, Kameyama K, Aiba M, Mukai M, Hara S, Ohigashi T et al. Non-functional adrenocortical adenoma with extensive degeneration. Pathol Int. 2003;53:241-5.
20. Chan K C, Chen PI, Huang ZH, Lin YM, Kuo PL. Adrenal myelolipoma with translocation (3;21) (q25;p11). Cancer Genet Cytogenet. 2002;134:77-80.
21. Wu Y, Chang KL, Weiss LM. Adrenal pseudocysts. Pathol Case Rev. 2005;10:263-68.
22. Carvounis E, Marinis A, Arkadopoulos N, Vascular adrenal cysts. A brief review of the literature, Arch Pathol Lab Med. 2006;130:1722-24.