Adrenal Myelolipoma in a Hemodialysis Patient – Case Report and Review of Literature

Myelolipoma is an uncommon adrenal tumor composed of a variable mixture of mature adipose tissue and hematopoietic elements that resemble the content of bone marrow. Adrenal glands are the commonest involved site, but other extra-adrenal sites are also reported. Myelolipoma is a benign lesion, usually small and unilateral, asymptomatic, and discovered by accident or at autopsy. Most myelolipomas do not cause an endocrine disorder, but cases associated with endocrine disorders have been reported. We report a 63-year-old female who had received regular hemodialysis for two years and the dialysis courses were smooth. She received abdominal ultrasonography to evaluate the source of fever and rightupper-quadrate abdominal pain and abnormal liver function. Accidentally, it revealed an 8.7 5.0 cm lesion over right suprarenal area. Abdominal computed tomography showed a fat-density, homogeneous right adrenal mass. No other intra-abdominal lesions, except bilateral contracted kidneys, could be noted. She was finally operated and histological examination showed that it was mainly composed of mature adipocytes. Hematopoietic cells, resembling the picture in bone marrow, were noted between the fat cells. To our knowledge, this is the first case report in uremic patient. Follow-up examinations showed no recurrence and patient stayed well on hemodialysis. (Acta Nephrologica 2001; 15: 118-121)