Presentation
Abdominal pain. Incidental finding on ultrasound exam.
Patient Data
Well-encapsulated ovoid mass of fatty density arising from the lateral limb of the left adrenal gland with no enhancement, calcification or hemorrhagic component in keeping with myelolipoma.
Normal appearance of the right adrenal gland.
Moderately enlarged fatty liver.
Case Discussion
CT features most consistent with adrenal myelolipoma.
The amount of fatty components is variable, ranging from only a few small regions in an otherwise mostly soft tissue density mass (10%) to masses made up of roughly equal components of fat and soft tissue (50%) or almost completely composed of fatty tissue (40%). Small punctate calcifications may be seen in 25-30% of cases.
The main differential diagnosis is adrenal lipoma which is extremely rare.
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