Presentation
Non-specific pain abdomen since 2 years
Patient Data
A well defined mixed signal intensity lesion involving right adrenal gland with demonstrable macroscopic fat content. The lesion is having abundant fat which is evidenced as T1 hyperintensity in the in and opposed phase images. LAVA Fat images show the fat content to advantage which is suppressed on the fat saturated Water LAVA, T2 images. The non-fatty component of the lesion shows T2 hyperintensity. Post-contrast study shows no significant enhancement in the lesion compared to the pre-contrast fat saturated T1 images. The lesion is abutting the posterior border of right lobe of liver segment VI. The lesion is lying posterior to the inferior vena cava without its deformation.
There is a well-defined T1 hypointense and T2 isointense incidentaloma without any obvious contrast enhancement in tail of pancreas.
Case Discussion
Adrenal myelolipomas are benign, lipomatous tumors with elements of myeloid cells, most of which present as adrenal incidentalomas and comprise 3·3-6·5% of all adrenal masses. Adrenal myelolipomas are usually unilateral (in 95% of cases) and affect both sexes. On imaging, show pathognomonic imaging features consistent with the presence of macroscopic fat. Large adrenal myelolipomas can cause symptoms of mass effect, and occasionally can be complicated by hemorrhage.
In this patient, ultrasound was done elsewhere which reveals adrenal lesion and hence MRI study was done.
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