Adrenokortikal adenomda myelolipomatöz değişiklikler

Year 2019, , 1135 - 1138, 30.09.2019

Canan Fırat Seda Eryiğit , Serkan Yener Tevfik Demir Ozan Bozkurt Ömer Demir Burçin Tuna , Kutsal Yörükoğlu

https://doi.org/10.17826/cumj.494051

Cited By: 3

Abstract

Myelolipoma is a rare benign tumor which is generally detected incidentally. The tumor consists of mature fat tissue and hematopoietic cells that resemble bone marrow. The coexistence of myelolipoma and non-functional adrenocortical adenoma in the same gland is exceedingly rare. We herein present two cases of adrenal myelolipoma in association with non-functional adrenocortical adenoma in left adrenal gland of a 62-year-old woman and non-functional adrenocortical adenoma combined with myelolipoma and endothelial cyst, in right adrenal gland of a 73-years-old man. Microscopically, in the central of the tumor, there was a myelolipomatous area composed of adipocytes and hematopoietic cells surrounded by sheets of adenoma cells. The histopathological diagnosis was “myelolipomatous changes within a non-functional adrenocortical adenoma”. The cases are presented here with their rarity and pathological differential diagnosis. 

Keywords

adrenal, Adenom, kortikal, myelolipom, non-fonksiyonel

Myelolipomatous changes within adrenocortical adenoma

Abstract

Myelolipoma is a rare benign tumor which is generally detected incidentally. The tumor consists of mature fat tissue and hematopoietic cells that resemble bone marrow. The coexistence of myelolipoma and non-functional adrenocortical adenoma in the same gland is exceedingly rare. We herein present two cases of adrenal myelolipoma in association with non-functional adrenocortical adenoma in left adrenal gland of a 62-year-old woman and non-functional adrenocortical adenoma combined with myelolipoma and endothelial cyst, in right adrenal gland of a 73-years-old man. Microscopically, in the central of the tumor, there was a myelolipomatous area composed of adipocytes and hematopoietic cells surrounded by sheets of adenoma cells. The histopathological diagnosis was “myelolipomatous changes within a non-functional adrenocortical adenoma”. The cases are presented here with their rarity and pathological differential diagnosis.

Keywords

Adenoma, adrenal, cortical, myelolipoma, non-functional

References

• Lerttumnongtum P, Muttarak M, Visrutaratna P and Charin Y. Imaging features of unusual adrenal masses. Australas Radiol, 2004; 48(2):107-13.
• Kenney P J, Wagner BJ, Rao P, Heffess CS, Myelolipoma: CT and pathologic features. Radiology, 1998; 208(1):87-95.
• Matsuda T, Abe H, Takase M, Arakawa A, Matsumoto T, Fujime M et al. Case of combined adrenal cortical adenoma and myelolipoma. Pathol Int, 2004; 54(9):725-9.
• Timonera E R, Paiva ME, Lopes JM, Eloy C, van der Kwast T and Asa SL. Composite adenomatoid tumor and myelolipoma of adrenal gland: report of 2 cases. Arch Pathol Lab Med, 2008;132(2):265-7.
• Armand R, Cappola AR, Horenstein RB, Drachenberg CB, Sasano H. and Papadimitriou JC, Adrenal cortical adenoma with excess black pigment deposition, combined with myelolipoma and clinical Cushing's syndrome. Int J Surg Pathol, 2004; 12(1):57-61.
• Vyberg M, and L Sestoft. Combined adrenal myelolipoma and adenoma associated with Cushing's syndrome. Am J Clin Pathol, 1986;86(4):541-5.
• Ammoury R F, Heptulla RA, Tatevian N and Elenberg E. Laparoscopic adrenalectomy of an adrenal adenoma with myelolipoma relieves severe hypertension in a 16-year-old patient. Pediatr Nephrol, 2006;21(3):433-6.
• Hisamatsu H, Sakai H, Tsuda S, Shigematsu K. and Kanetake H. Combined adrenal adenoma and myelolipoma in a patient with Cushing's syndrome: case report and review of the literature. Int J Urol, 2004;11(6):416-8.
• Caliumi C, De Toma G, Bossini A, Cianci R, Bosman C, Genuardi M et al. A rare combination consisting of aldosterone-producing adenoma and adrenal myelolipoma in a patient with heterozygosity for retinoblastoma (RB) gene. J Renin Angiotensin Aldosterone Syst, 2004;5(1):45-8.
• Sun X, A Ayala, and C Y Castro. Adrenocortical carcinoma with concomitant myelolipoma in a patient with hyperaldosteronism. Arch Pathol Lab Med, 2005;129(6):144-7.
• Ukimura O, Inui E, Ochiai A, Kojima M and Watanabe H. Combined adrenal myelolipoma and pheochromocytoma. J Urol, 1995;154(4):1470.
• Merchant S H, Herman CM, Amin MB, Ro JY and Toroncoso P. Myelolipoma associated with adrenal ganglioneuroma. Arch Pathol Lab Med, 2002;126(6):736-7.
• Lewitowicz P, Wincewicz A, Horecka-Lewitowicz A, Matykiewicz J, Kozieł D, Głuszek S et al. Coexistence of renal cell carcinoma of clear cell type with sarcomatoid cell type component and adrenal mature ganglioneuroma with myelolipoma - a case of 69-year-old female patient. Rom J Morphol Embryol, 2014;55(2):425-32.
• Mahe E, and I El-Shinnawy. A "tumour trifecta:" myelolipomata arising within an adrenocortical adenoma ipsilateral to a synchronous clear cell renal cell carcinoma. Malays J Pathol, 2010;32(2):123-8.
• Weiner S, Bernstein RG, Lowy S and Karp H. Case report. Combined adrenal adenoma and myelolipoma. J Comput Assist Tomogr, 1981;5(3):440-2.
• Gurbuz E, Sayar H, Bakaris S and Inci MF. Adrenal myelolipoma's connection with adenoma in the same adrenal gland. BMJ Case Rep. 2013;2013.
• Ong K, K B Tan and T C Putti. Myelolipoma within a non-functional adrenal cortical adenoma. Singapore Med J, 2007;48(7):200-2.
• Manassero F, Pomara G, Rappa F, Cuttano MG, Crisci A and Selli C. Adrenal myelolipom associated with adenoma. Int J Urol, 2004;11(5):326-8.
• Yamada S, Tanimoto A, Wang KY, Ding Y, Guo X, Shimajiri S et al. Non-functional adrenocortical adenoma: a unique case of combination with myelolipoma and endothelial cysts. Pathol Res Pract, 2011;207(3):192-6.
• Al-Brahim N and S Asa. Myelolipoma with adrenocortical adenoma: an unusual combination that can resemble carcinoma. Endocr Pathol, 2007;18(2): p103-5.
• Bisho E, Eble JN, Cheng L. Adrenal myelolipomas show nonrandom X-chromosome inactivation in hematopoietic elements and fat: support for a clonal origin of myelolipomas, Am J Surg Pathol. 2006;(30):838–843.
• Nigawara T, Sakihara S, Kageyama K, Endothelial cyst of the adrenal gland associated with adrenocortical adenoma: preoperative images simulate carcinoma, Intern Med. 2009;(48):235-240.
• Goetz S P, Niemann TH, Robinson RA and Cohen MB. Hematopoietic elements associated with adrenal glands. A study of the spectrum of change in nine cases. Arch Pathol Lab Med, 1994;118(9):895-6.
• Gierke E. Uber knochenmarksgewebe in der Nebenniere. Beitr Z. Pathol. Anat., 1905; 37(311):25.
• Abecassis M, McLoughlin MJ, Langer B and Kudlow JE. Serendipitous adrenal masses: prevalence, significance, and management. Am J Surg, 1985;149(6):783-8.
• Lockhart M E, J.K. Smith and P J Kenney. Imaging of adrenal masses. Eur J Radiol, 2002; 41(2):95-112.
• Brietta L K and D Watkins. Giant extra-adrenal myelolipoma. Arch Pathol Lab Med, 1994; 118(2):188-90.
• Rocher L, Youssef N, Tasu JP, Paradis V and Bléry M. Adrenal pheochromocytoma and controlateral myelolipoma. Clin Radiol, 2002;57(6):535-7.
• Cormio L, Ruutu M, Giardina C and Selvaggi FP. Combined adrenal adenoma and myelolipoma in a patient with Conn syndrome. Case report. Panminerva Med, 1992;34(4):209-12.
• Miyake O, Hara T, Matsumiya K, Oka T, Takaha M and Kurata A. Adrenal myelolipoma associated with Cushing's syndrome: a case report. Hinyokika Kiyo, 1992;38(6):681-4.
• Pasimeni G, Rossi F, Ragazzo M, Guerrini L, Markouizou A and Santiemma V. Adrenal adenoma and myelolipoma in an elderly patient with Conn's syndrome. Recenti Prog Med, 2000;91(3):116-8.
• Plaut A. Myelolipoma in the adrenal cortex; myeloadipose structures. Am J Pathol, 1958; 34(3):487-515.
• Minja E J, Pellerin M, Saviano N and Chamberlain RS. Retroperitoneal extrarenal angiomyolipomas: an evidence-based approach to a rare clinical entity. Case Rep Nephrol, 2012;2012:374107.
• Kwazneski Ii D, Merrill M, Young J and Sell H Jr, Angiomyolipoma and Malignant PEComa: Discussion of Two Rare Adrenal Tumors. Case Rep Oncol Med, 2016;2016: 5204092.
• Fletcher C. Tumors of Soft Tissue, in Diagnostic Histopathology of Tumors, C. Fletcher, Editor. 2013;Elsevier Saunders: Philadelphia.1804-1807.
• Lam K Y and C Y Lo. Adrenal lipomatous tumours: a 30 year clinicopathological experience at a single institution. J Clin Pathol, 2001;54(9):707-12.
• Lesbats-Jacquot V, Cucchi JM, Amoretti N, Novellas S, Chevallier P and Bruneton JN. Lipomatous tumors of the adrenals--a report on 18 cases and review of the literature. Clin Imaging, 2007;31(5):335-9.
• Marino-Enriquez A, Fletcher CD, Dal Cin P and Hornick JL Dedifferentiated liposarcoma with "homologous" lipoblastic (pleomorphic liposarcoma-like) differentiation: clinicopathologic and molecular analysis of a series suggesting revised diagnostic criteria. Am J Surg Pathol, 2010;34(8):1122-31.
• Val-Bernal J, Azueta A, Ortiz-Rivas LA, Fuentes J and Ballestero R. Incidental lipoma-like hibernoma arising from the adrenal gland: a well-differentiated liposarcoma mimicker. Pathol Res Pract, 2013;209(12):812-6.
• Neiman R, Barcos M, Berard C, Bonner H, Mann R, Rydell RE et al. Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer, 1981;48(6):1426-37.
• Fowler M R, Williams RB, Alba JM and Byrd CR Extra-adrenal myelolipomas compared with extramedullary hematopoietic tumors: a case of presacral myelolipoma. Am J Surg Pathol, 1982;6(4):363-74.
• Masugi Y, Kameyama K, Aiba M, Mukai M, Hara S, Ohigashi T et al. Non-functional adrenocortical adenoma with extensive degeneration. Pathol Int, 2003;53(4):241-5.
• Chan K C, Chen PI, Huang ZH, Lin YM and Kuo PL. Adrenal myelolipoma with translocation (3;21)(q25;p11). Cancer Genet Cytogenet, 2002;134(1):77-80.
• Wu Y, Chang KL, Weiss LM. Adrenal pseudocysts. Pathol Case Rev. 2005;10:263-268.
• Carvounis E, Marinis A, Arkadopoulos N, Vascular adrenal cysts. A brief review of the literature, Arch Pathol Lab Med. 2006;130:1722-1724.
• Torres C, Ro JY, Batt MA, Vascular adrenal cysts: a clinicopathologic and immunohistochemical study of six cases and a review of the literature, Mod Pathol. 1997;10:530–536.