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Endocrine

, Volume 58, Issue 2, pp 289–294 | Cite as

The radiographically diagnosed adrenal myelolipoma: what do we really know?

  • Michael J. Campbell
  • Mary Obasi
  • Bingling Wu
  • Michael T. Corwin
  • Ghaneh Fananapazir
Original Article

Abstract

Purpose

Adrenal myelolipomas are uncommon, benign tumors of the adrenal glands that are not routinely evaluated for autonomous hormone secretion or followed by repeat imaging, but may lead to retroperitoneal hemorrhage. Little is known about the natural history these tumors with the majority of previous publications being confined to case reports and small case series.

Methods

We reviewed the computed tomography (CT) reports of 62,279 patients evaluated at a tertiary referral center between 2002 and 2015 for the presence of an adrenal myelolipoma >1 cm in size. We then reviewed the CT imaging and patient charts to determine tumor size, growth, evidence of retroperitoneal hemorrhage, and endocrine dysfunction.

Results

We identified 150 (0.24%) patients with 155 radiographically diagnosed adrenal myelolipomas found on a CT scan during our study period. The median tumor size at discovery was 2.1 cm. Twelve (7.7%) tumors were >6 cm. Sixty-nine (46%) patients had a follow-up CT with a mean time interval between scans of 3.9 years. Eleven tumors (16%) grew over our follow-up period with a median growth rate of 0.16 cm/year. No patient developed a retroperitoneal hemorrhage. Twenty (13%) patients underwent an evaluation for endocrine dysfunction. Three patients had evidence of hypercortisolism and one patient had primary aldosteronism.

Conclusion

The majority of radiographically diagnosed adrenal myelolipomas found on abdominal CT imaging are small and slow growing. Retroperitoneal hemorrhage is uncommon, but the rate of associated endocrine dysfunction may be underestimated.

Keywords

Adrenal myelolipoma Adrenal incidentaloma Hypercortisolism 

Notes

Acknowledgments

Department funds were used for incidental expenses. All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The requirement for informed consent was waived for this study by our institutional review board.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Michael J. Campbell
    • 1
  • Mary Obasi
    • 1
  • Bingling Wu
    • 1
  • Michael T. Corwin
    • 1
  • Ghaneh Fananapazir
    • 1
  1. 1.Departments of Surgery and RadiologyUniversity of California, Davis Medical CenterSacramentoUSA

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