title: Laparoscopic hand-assisted adrenal sparing surgery for a giant adrenal myelolipoma: A case report.
abstract: BACKGROUND
  Adrenal myelolipoma is a rare, benign tumor. Surgical resection is advocated in case of symptomatic, large size (> 4cm), increase of size on follow-up and atypical appearance on imaging. Laparoscopic adrenalectomy is currently the gold standard operation for managing benign adrenal mass. However, to date, laparoscopic entire resection of ipsilateral adrenal gland with the tumor have been mainly reported in the literature. Under clinical circumstances, adrenal sparing surgery underused as first-line therapy for adrenal tumors.
  
  
  METHODS
  We present a case of adrenal myelolipoma involving the right adrenal gland of a 45-year-old woman who presented with right-sided flank pain. On radiologic and endocrine evaluation, she was diagnosed with a giant adrenal myelolipoma (> 8cm). Right hand-assisted laparoscopic partial adrenalectomy was performed, and postoperative recovery was uneventful. Finally, histological examination confirmed adrenal myelolipoma. On follow-up computed tomography, there was no residual tumor and the remaining right adrenal gland.
  
  
  CONCLUSIONS
  Our report suggests that hand-assisted laparoscopic partial adrenalectomy could be considered for appropriate removal of adrenal myelolipoma, even in giant adrenal myelolipoma.
authors.affiliation: a Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-Si, 480-717, Korea, Republic of.
authors.forename: Bong Hee
authors.initials: BH
authors.lastname: Park
authors.forename: Su Lim
authors.initials: SL
authors.lastname: Lee
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Seo
authors.forename: Sang Rak
authors.initials: SR
authors.lastname: Bae
authors.forename: Yong Seok
authors.initials: YS
authors.lastname: Lee
authors.forename: Sung Hak
authors.initials: SH
authors.lastname: Kang
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Han
keywords: adrenal glands; adrenalectomy; hand-assisted laparoscopy; myelolipoma