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Introduction <p>Adrenal myelolipoma within an adrenal cortical adenoma is a rare, benign tumor composed of mature adipose tissue and hematopoietic elements. It is often an incidental radiological finding; however, larger lesions may present with abdominal pain or haemorrhage.</p> Case presentation <p>A 24-year-old male presented with hypertension and clinical features suggestive of Cushing syndrome, along with nonspecific flank pain. Cross-sectional imaging showed a large heterogeneous left suprarenal mass containing fat, cystic change, and peripheral calcification. The patient underwent open left adrenalectomy. Histopathological examination demonstrated a predominant adrenal cortical adenoma with focal areas of mature adipocytes and trilineage haematopoiesis consistent with myelolipoma.</p> Discussion <p>Coexistence of an adenomatous cortical lesion and myelolipomatous foci is uncommon. Distinction between fat-containing adrenal benign lesions and malignant retroperitoneal neoplasms relies on careful radiologic assessment (macroscopic fat, well-circumscription, lack of infiltrative features) and histopathology. We briefly review the literature on combined lesions and briefly discuss hypotheses for their pathogenesis.</p> Conclusion <p>Recognition of myelolipomatous foci in adrenal cortical lesions is important to avoid misclassification and overtreatment. Multidisciplinary approach including clinicians, radiologists, and pathologists is essential for appropriate management.</p>

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Adrenal Cortical Adenoma with Myelolipomatous Foci in a Young Male: A Case Report and Brief Review of the Literature

  • 期刊论文

  • 发表日期：

    2026年4月1日

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  • Bhoomika Kaushik,
  • Rakesh Kumar Gupta,
  • Amit R. Sharma

摘要

Introduction

Adrenal myelolipoma within an adrenal cortical adenoma is a rare, benign tumor composed of mature adipose tissue and hematopoietic elements. It is often an incidental radiological finding; however, larger lesions may present with abdominal pain or haemorrhage.

Case presentation

A 24-year-old male presented with hypertension and clinical features suggestive of Cushing syndrome, along with nonspecific flank pain. Cross-sectional imaging showed a large heterogeneous left suprarenal mass containing fat, cystic change, and peripheral calcification. The patient underwent open left adrenalectomy. Histopathological examination demonstrated a predominant adrenal cortical adenoma with focal areas of mature adipocytes and trilineage haematopoiesis consistent with myelolipoma.

Discussion

Coexistence of an adenomatous cortical lesion and myelolipomatous foci is uncommon. Distinction between fat-containing adrenal benign lesions and malignant retroperitoneal neoplasms relies on careful radiologic assessment (macroscopic fat, well-circumscription, lack of infiltrative features) and histopathology. We briefly review the literature on combined lesions and briefly discuss hypotheses for their pathogenesis.

Conclusion

Recognition of myelolipomatous foci in adrenal cortical lesions is important to avoid misclassification and overtreatment. Multidisciplinary approach including clinicians, radiologists, and pathologists is essential for appropriate management.