Adrenal myelolipomas (AMLs) are rare slow-growing non-malignant tumors that comprise both adipose and haematopoietic tissue and are caused by metaplasia of the reticuloendothelial cell. It is a type of incidentaloma which is an uncommon adrenal mass usually asymptomatic and identified during imaging investigation for reasons other than adrenal gland disorders. Myelolipomas vary in size but can be as large as 30 cm. These large myelolipomas can cause pressure on nearby structures resulting in clinical symptoms and signs.
This case report and literature review detail the
diagnostic, medical and surgical management of a 14-year-old male with sickle
cell anaemia who had a giant adrenal myelolipoma which was symptomatic. He had
a one-week history of bilateral leg swelling and physical examination showed a
mass in the right lumbar region. Abdominopelvic ultrasound revealed a
suprarenal right-sided mass displacing the right kidney downwards. It was
characterized as encapsulated, echo-complex, rounded and well-defined. The mass
was also exerting pressure on the upper part of the kidney, and significantly
compressing the inferior vena cava. A computed tomography (CT) scan revealed a
large mass tenanting the right adrenal gland. He subsequently had an
exploratory laparotomy with excision of the adrenal tumour.
Immunohistochemistry analysis of the mass confirmed the diagnosis of an adrenal
myelolipoma.
Conclusively, the diagnosis of an adrenal myelolipoma
necessitates a high index of suspicion, a detailed medical history, a thorough
physical examination, imaging studies and a meticulous histopathology
investigation. Surgical intervention is the primary treatment method, while
effective postoperative care ensures rapid recovery with minimal complications.
Author (s) Details
Udochikwuka Patience
Ikejiaku
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State,
Nigeria.
Chidinma Adaobi Udah
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State,
Nigeria.
Johnpatrick Uchenna
Ugwoegbu
Department of Radiology, Federal Teaching Hospital, Owerri, Imo State,
Nigeria.
Emeka Nwolisa
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State,
Nigeria.
Uzoma Onwukwe
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State,
Nigeria.
Lilian Ezeuko
Department of Paediatrics, Federal Teaching Hospital, Owerri, Imo State,
Nigeria.
Please see the book here:- https://doi.org/10.9734/bpi/msti/v5/4208
No comments:
Post a Comment