Laparoscopic removal of a giant adrenal myelolipoma: A case report with review of the literature

Abstract

Introduction

Adrenal myelolipomas (AMLs) are non-functioning, benign adrenal tumors with an unknown etiology. This study aims to report a case of giant AML managed successfully by laparoscopic surgery.

Case presentation

A 43-year-old man presented with mild, dull, and non-radiating left loin pain. Physical examination and hormonal assays were normal. Imaging revealed a retroperitoneal mass (13 × 12 × 8.5cm) containing gross fat. Left laparoscopic adrenalectomy was done under general anesthesia. The postoperative period was uneventful. The patient was followed up for a duration of six months, and no recurrence was detected.

Discussion

AMLs are lipomatous tumor-like growths equally seen in both genders and are commonly incidental findings. Symptomatic AMLs are characterized by their large size, leading to the manifestation of pressure-related symptoms or abnormalities in hormonal levels. Most AMLs are associated with chronic diseases like diabetes mellitus and hypertension. The tumor is commonly diagnosed through a biochemical and imaging workup. Asymptomatic AMLs are managed conservatively, while in the presence of symptoms, surgery is usually considered. However, the open approach is regarded as the standard option, but minimally invasive approaches can be carried out due to their feasibility.

Conclusion

AMLs are rare, benign, non-functional tumors of the adrenal gland. Laparoscopy may be a safe and feasible management modality for these tumors.