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      Mielolipoma adrenal bilateral ligado a hipotiroidismo primario Translated title: Bilateral adrenal myelolipoma linked to primary hypothyroidism

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          Abstract

          Los mielolipomas adrenales son tumores benignos, no funcionantes e infrecuentes, generalmente de diagnóstico incidental, que eventualmente provocan síntomas locales. Tras una revisión de la literatura previa publicada, se realizó la descripción de un caso clínico de mielolipoma adrenal bilateral, que coexiste con hipotiroidismo primario, relación no reportada hasta el presente. Dichas masas tumorales se diagnosticaron en una mujer de 66 años, aquejada de dolor abdominal recurrente, que además padecía hipotiroidismo e hipercolesterolemia, a la que se le practicó con éxito la exéresis de la lesión de mayor tamaño. Se propuso un tratamiento diagnóstico-terapéutico para este tipo de tumores.

          Translated abstract

          The adrenal myelolipomas are benign tumors, non-functioning and infrequent, generally of incidental diagnosis which by chance provoke local symptoms. After a review of published previous literature it was possible to describe of a clinical case of bilateral adrenal myelolipoma coexisting with a primary hypothyroidism with a relation not reported until now. Such tumoral masses were diagnosed in a woman aged 66 with recurrent abdominal pain and hypothyroidism and hypercholesterolemia who undergoes successfully a exeresis of the bigger lesion. A diagnostic-therapeutic treatment was proposed for this type of tumors.

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          Most cited references59

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          Adrenal incidentaloma and patients with homozygous or heterozygous congenital adrenal hyperplasia.

          Adrenal tumors are being detected more frequently in consequence of the wider application of increasingly sensitive radiological investigation techniques. According to the working hypothesis that more silent adenomas could develop from hyperplastic tissue areas under increased stimulation of the adrenal cortex, heterozygous and homozygous patients with congenital adrenal hyperplasia (CAH) were studied. A high incidence of adrenal masses, nearly 82% in homozygous and 45% in heterozygous patients, was found. There was no correlation between tumor size and serum 17-hydroxyprogesterone concentrations. These tumors are, therefore, probably silent adenomas. On the basis of these results, CAH should always be ruled out in the case of incidentally detected adrenal masses. Since CAH is a relatively frequent disease, and the adrenal carcinoma belongs to the rarest malignant tumors, a malignant transformation of these tumors seems to be unlikely.
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            Combined adrenal adenoma and myelolipoma in a patient with Cushing's syndrome: case report and review of the literature.

            Myelolipoma is an uncommon benign tumor of unknown etiology and adrenal myelolipoma is rarely associated with endocrine disorders. We report a 67-year-old woman with Cushing's syndrome due to left adrenal adenoma associated with myelolipoma. The patient underwent laparoscopic left adrenalectomy and pathological examination revealed an adrenocortical adenoma associated with myelolipoma. To the best of our knowledge, 25 cases of endocrine dysfunction associated with myelolipoma have been reported in the English and Japanese literature. We review and discuss the pathogenesis of adrenal myelolipoma.
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              Bilateral thoracic extraadrenal myelolipoma.

              Myelolipoma commonly occurs in the adrenal gland and is composed of both adipose tissue and normal hematopoietic elements. Extraadrenal myelolipoma may occur in the retroperitoneum, stomach, liver, lung, and in 3% of cases even in the mediastinum. We present a 65-year-old female patient with unspecific clinical symptoms. Routine chest roentgenograms revealed bilateral widening of the posterior mediastinum. Computed tomography showed bilateral, paravertebral lesions of 4.5 and 6.5 cm in diameter, respectively. After surgical removal, bilateral thoracic myelolipoma was pathomorphologically diagnosed. The imaging differential diagnosis of bilateral solid lesions in the posterior mediastinum including lymph node metastases, lymphomas, neurogenic tumors and extramedullary hematopoietic tumors is discussed.
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                Author and article information

                Journal
                end
                Revista Cubana de Endocrinología
                Rev Cubana Endocrinol
                Editorial Ciencias Médicas (Ciudad de la Habana, , Cuba )
                1561-2953
                December 2010
                : 21
                : 3
                : 323-332
                Affiliations
                [01] Ciudad de La Habana orgnameInstituto Nacional de Endocrinología Cuba levisg@ 123456infomed.sld.cu
                [02] La Habana orgnameHospital Universitario Comandante Manuel Fajardo Cuba
                Article
                S1561-29532010000300006 S1561-2953(10)02100306
                bebd7734-e718-4dd4-ba4d-c2bd7c191587

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 01 July 2010
                : 07 October 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 42, Pages: 10
                Product

                SciELO Cuba

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                PRESENTACIÓN DE CASOS

                Myelolipoma,adrenal tumor,incidentaloma,Mielolipoma,tumor adrenal

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