A 45-year-old male presented with left flank pain. Imaging found a 9x10 cm retroperitoneal mass. Biopsy indicated myelolipoma, a benign adrenal tumor composed of adipose and hematopoietic cells. Surgical excision was recommended as treatment for this adrenal myelolipoma.

2. CASE 11

3. • 45year male
• Presented with left flank pain
• USG: 9X10 cm mass lesion was noted in the
left lumbar retroperitoneal region.
• FNAC- under guidance

10. • Other investigations: RFT, LFT, routine
biochemical investigations
• Complete hemogram
• USG : retroperitoneal sarcoma
• CT: Liposarcoma

14. Response
• Soft tissue tumour
• Malignant vascular tumour
• Paraganglioma

16. MYELOLIPOMA

17. 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.

18. Myelolipomas account for approximately 3 to 5% of all
primary adrenal tumors.
Thought to arise from metaplasia of undifferentiated
stromal cells.
5th to 7th decades of life
Usually solitary

19. 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.

20. • 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