CASE 11

• 45year male

• Presented with left flank pain

• USG: 9X10 cm mass lesion was noted in the left lumbar retroperitoneal region.

• FNAC- under guidance

• Other investigations: RFT, LFT, routine

biochemical investigations

• Complete hemogram

• USG : retroperitoneal sarcoma

• CT: Liposarcoma

Response

• Soft tissue tumour

• Malignant vascular tumour

• Paraganglioma

MYELOLIPOMA

ADRENAL MYELOLIPOMA

Adrenal myelolipoma is a benign tumour.

In 1905 Gierke first described the occurrence of a mass lesion in the adrenal glands.

They were subsequently termed formations myelolipomatoses by Oberling in 1929.

Myelolipomas account for approximately 3 to 5% of allprimary adrenal tumors.

Thought to arise from metaplasia of undifferentiatedstromal cells.

5th to 7th decades of life

Usually solitary

Associations :

with overproduction of dehydroepiandrosterone-

sulphate (DHEAS),

congenital adrenal hyperplasia caused by 21-

hydroxylase deficiency,

congenital adrenal 17 α-hydroxylase deficiency,

Cushing disease,

Conn syndrome,

adrenal insufficiency, and pheochromocytoma.

• Gross: capsulated, lobulated, yellow to red brown depending upon the relative proportion of fat and myeloid cells.

• Microscopy: islands of fat cells intermixed with hematopoietic stem ells, mainly myeloid and erythroid precursors, along with scattered megakaryocytes.

• SURGICAL EXCISION