A Distinctive Case Report Highlighting the Occurrence of a Rare Gigantic Adrenal Myelolipoma in a Patient with Sickle Cell Anaemia | Chapter 10 | Medical Science: Trends and Innovations Vol. 5

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

Study on Primary Adrenal Insufficiency (PAI): Experience in a Major Teaching Hospital, Riyadh, Saudi Arabia | Chapter 7 | New Frontiers in Medicine and Medical Research Vol. 10

 Primary adrenal insufficiency (PAI) in children is a rare but potentially fatal condition. Weakness, weariness, anorexia, abdominal pain, weight loss, orthostatic hypotension, salt desire, and hyperpigmentation are some of the current symptoms.

The goal of this research was to determine the cause of PAI in a big referral, teaching hospital in Riyadh, Saudi Arabia.

Materials and Procedures: This is a retrospective hospital-based study that took place between January 1989 and December 2014 at King Khalid University Hospital (KKUH). Medical records of a patient diagnosed with primary adrenal insufficiency were reviewed. The diagnosis was made based on the patient's medical history, physical examination, and low glucocorticoid levels and elevated adrenocorticotropic hormone levels (ACTH). The results of appropriate laboratory and radiographic tests were also examined.

Results: A total of 125 individuals with primary adrenal insufficiency were seen between January 1989 and December 2014. 85.5 percent of the participants had inherited diseases such as congenital adrenal hyperplasia and hypoplasia. Variable autoimmune-mediated etiologic diagnosis, which accounted for 13% of the cases, was also seen. Various laboratory and radiological investigations should be planned as needed.

Conclusion: Although congenital adrenal hyperplasia was the most common cause, congenital adrenal hypoplasia should also be considered. In some cases, determining the presence of PAI can be difficult, hence suitable serological testing is recommended.

Author (S) Details

N. A. Al-Jurayyan
Department of Pediatrics, College of Medicine and King Khalid University Hospital (KKUH), King Saud University Medical City, Riyadh, Saudi Arabia.

View Book :- https://stm.bookpi.org/NFMMR-V10/article/view/3506