Surgical management of adrenal myelolipoma: a series of 10 patients and review of the literature.
OBJECTIVE
Adrenal myelolipomas have been conventionally described as asymptomatic tumors that are easily diagnosed and can be managed conservatively. The purpose of this study is to evaluate the role of surgery in the management of these lesions.


METHODS
The clinical presentation, the operative treatment and histopathological features of 10 patients with myelolipoma over a 13-year period in a tertiary care Center are presented.


RESULTS
Eight patients (80%) were symptomatic: 7 patients presented with non-specific abdominal pain, whereas 1 patient presented urgently due to intraperitoneal hemorrhage. Investiga-tion of concurrent medical conditions revealed hypertension (7 patients), diabetes mellitus (2 patients), obesity (4 patients) and nephrolithiasis (1 patient). Seven patients underwent adrenalectomy by open approach (4 through the anterior and 3 through the posterior route) and 3 by laparoscopic method. There was no postoperative morbidity and mortality and all patients are currently symptom free.


CONCLUSIONS
Although myelolipomas are considered as innocent benign growths, they may present with acute clinical symptoms. Surgical therapy is a safe and definitive treatment option for both symptomatic and ''asymptomatic'' lesions providing definitive diagnosis and alleviating the patients' symptoms along with the emotional burden due to tumor presence.
Kiriakopoulos
A
A
Department of Surgery, 'Hygeia'' Hospital, Athens, Greece.
Tsakayannis
D
D
Linos
D
D