Presentation
Workup for abdominal pain.
Patient Data
A large well-defined fat-ontaining mass lesion was noted in the right adrenal gland. Soft tissue elements (myeloid components) were noted in the tumoral mass. After IV contrast media injection, mild enhancement is evident at these areas. The right kidney is displaced posteroinferiorly . Local invasion was not evident.
Another smaller fat containing lesion was seen in the left adrenal gland.
A large well defined heterosignal mass is seen at right suprarenal region. The mass seems to be originating from right adrenal gland and causing inferior displacement of the right kidney. The mass contains areas with fat and soft tissue signal intensity. After contrast injection, nonfatty components of the mass show heterogeneous enhancement. The mass has pressure effect on the IVC but there is no sign of vascular invasion.
Another small similar mass is seen in the left adrenal gland too.
Case Discussion
Bilateral adrenal gland masses containing both fat and soft tissue elements, myelolipoma is the most likely diagnosis. Adrenal myelolipomas are uncommon tumors, usually non-functioning, and they are often found incidentally. Myelolipomas are composed of fat and hemopoietic cells surrounded by a thin capsule. In most cases they are unilateral.
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