Background: Adrenal myelolipoma is a rare, benign neoplasm of the adrenal cortex characterized
by a mixture of mature adipose tissue and hematopoietic elements, including erythroid, myeloid, and
megakaryocytic lineages. Typically asymptomatic and non-functional, these tumors are often discovered
incidentally during imaging for unrelated conditions. Larger lesions, however, may present with
symptoms due to mass effect or hemorrhage.
Case presentations:
Case 1: A 56-year-old female with a history of gastroesophageal reflux disease (GERD) presented with
hematemesis. Abdominal CT revealed a left adrenal nodule, which was monitored for 18 months. Due
to growth and abdominal discomfort, she underwent left adrenalectomy. Histopathology confirmed a
benign adrenal myelolipoma.
Case 2: A 47-year-old male with abdominal pain and hematuria was found to have a large right adrenal
mass on CT. Despite an elevated aldosterone-to-renin ratio, the lesion was not hormonally functional.
Right adrenalectomy was performed, and histology confirmed myelolipoma.
Case 3: A 57-year-old male undergoing routine health screening was incidentally found to have two
well-defined lesions in the left adrenal gland on abdominal ultrasound and CT. Both lesions were
resected, and histopathology revealed benign adrenal myelolipomas.
Conclusion: Adrenal myelolipomas are rare benign tumors that are often incidentally discovered during
imaging. While they are typically non-functional and asymptomatic, larger or symptomatic lesions
require surgical resection. Early diagnosis, careful imaging interpretation, and histopathological
examination are crucial for ensuring appropriate management and distinguishing these tumors from
other adrenal pathologies.
