TY - JOUR AU - Oluwaseun Adelekan AU - Bhumika Gharia AU - Salama Samih PY - 2025 DA - 2025/11/20 TI - Adrenal Myelolipoma: Clinicopathological Spectrum Across Three Cases JO - Case Reports and Reviews VL - 5 IS - 5 AB - 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. SN - 2693-1516 UR - https://dx.doi.org/10.33425/2693-1516.1067 DO - 10.33425/2693-1516.1067