January - March 2017, Volume 13, Issue 1

Jeon HJ, Lee SY

A Case of Adrenal Myelolipoma a Patient with Breast Cancer

Acta Endo (Buc) 2017, 13 (1): 90-95
doi: 10.4183/aeb.2017.90

Background. Adrenal myelolipoma is a rare benign tumor composed of adipose tissue and hematopoetic elements resembling bone marrow. The majority of myelolipoma do not produce adrenal hormones and are only found as a result of evaluation for another disorder. With the widespread use of non-invasive abdominal imaging for various reason, its incidental detection has become more common. There are a few cases of breast cancer with concomitant adrenal myelolipoma in the literature. Case. A 43-year-old woman presented to endocrine clinic due to presurgical assessment of adrenal mass prior breast cancer surgery. Abdominal CT showed a 9 x 8 cm sized, lobulated contour heterogeneous fatty density mass with peripheral calcification in right adrenal gland. Hormonal studies for adrenal incidentaloma revealed: Aldosterone/ Renin ratio, 0.70 ([normal range < 30]; normal DHEA-S, 85.0 μg/dL ([normal range, 80 -560 μg/dL]), ACTH 25 pg/ mL ([normal range, 10 – 60 pg/mL]), morning serum cortisol 8.9 μg/dL ([normal range, 5 - 12 μg/dL]). In 24-hour urine, there revealed free cortisol 21.6 μg/day ([normal range, 10 – 50 μg/day); metanephrine 0.19 mg/day ([normal range < 0.8 mg/day]); 17-ketosteroid 14.06 mg/day ([normal range, 7 – 20 mg/day]). The hormonal results of adrenal mass revealed as nonfunctioning. The adrenal mass was surgically resected in order to rule out malignancy. Pathology report showed myelolipoma. Conclusion. We reported a case of adrenal myelolipoma coexisting with breast cancer where the diagnosis was made incidentally based on radiological features, treated with surgical resection.

Keywords: adrenal Myelolipoma, breast cancer, adrenal incidentaloma.

Correspondence: Hyun Jeong Jeon MD, Chunbguk National University, Dept of Internal Medicine, 52 NaeSuDong-Ro, HeungDuk-Gu Cheong-Ju, Chungcheongbuk-do, 361-763, Republic of Korea, E-mail: endoann@daum.net