ORIGINAL ARTICLE
MYELOLIPOMA COEXISTENCE WITH GLUCOCORTICOID
AND ANDROGEN SECRETING ADRENOCORTICAL CARCINOMA:
SLOW AND BENIGN CLINICAL COURSE
Taner Demirci, Hasret Cengiz, Sedat Cetin, Ceyhun Varim, Gizem Karatas Kiliccioglu.
Sakarya University, Medicine Faculty, Department of Internal Medicine, Division of Endocrinology;
Department of Endocrinology; Department of Internal Medicine; Sakarya University, Turkey
Summary
We present a case of androgen and glucocorticoid secreting adrenocortical carcinoma with concomitant myelolipoma. A giant adrenal tumor which was initially nonfunctional was reassessed four years later due to the patient's refusal to treat.
The patient was a 48-year-old woman with hypertension and acne lesions on the face. Laboratory findings were consistent with glucocorticoid and androgen hypersecretion. Computed tomography revealed a heterogeneously contrasting mass of 145xl18x100 mm with lobular contour and soft tissue areas. The patient underwent left laparoscopic transperitoneal adrenalectomy with three port technique. There were no complications in the perioperative period. The resected specimen weighed 850 grams. Pathological findings showed a combi- nation of myelolipoma-adrenal cortical cancer. In the postoperative period, hypertension improved and the hormone panel was normalized. Postoperative computed tomography and PET-CT showed no residual mass and metastasis. Although imaging is compatible with benign masses such as myelolipoma, coexistence of ACC-myelolipoma should be kept in mind and functional evaluation should be performed.
Keywords
Myelolipoma
Adrenocortical Carcinoma
Cushing Syndrome Hyperandrogenism