Myelolipoma : Clinical Features

Comments:
Clinical Features: Most myelolipomas are small, non-functioning and asymptomatic and often detected incidentally on imaging studies or surgery for an unrelated cause or at autopsy.

Some tumors can reach enormous size and produce symptoms associated with a large abdominal mass such as sense of fullness, abdominal pain, nausea, vomiting, constipation, dysuria or hematuria. Rare cases can spontaneously rupture producing massive retroperitoneal hemorrhage. Many cases occur in association with functioning adrenal tumors/lesions resulting in Cushing syndrome, Conn syndrome, Addison disease, and congenital adrenal hyperplasia (giant bilateral myelolipomas).

Imaging: This MRI with contrast (coronal T1) image is from a 60 y/o male who presented with right flank pain and was found to have a right retroperitoneal mass on ultrasonography. The image shows a 10 x 7 cm, ovoid right suprarenal mass with smooth contours and mixed densities, predominantly gross fat. The non-fatty component shows contrast enhancement. The right kidney is displaced downward by the mass. The imaging findings are classic for myelolipoma. Case courtesy of Mostafa El-Feky, Radiopaedia.org. From the case rID: 65240