A 62-year-old female patient, obese, with diabetes and hypertension for one year.
Six months ago she complained of low intensity sporadic right lumbar pain.
Physical examination was normal.
Abdominal ultrasound showed a hypoechogenic right adrenal mass of 80 mm compressing the upper pole of the right kidney.
A descending urogram showed an expansive process in the right adrenal gland, the upper pole of the right kidney displaced toward the lower pole.
The CT scan showed a tumoral mass with a diameter greater than 8.7 x 76 cm with irregular contours heterogeneous density of 100 - 37 HU, partitioned, compatible with an adrenal tumor of fat density.
Figure 1
1.
The hormonal study for cortisol determination was normal.
The patient underwent surgery by lumbar approach.
The transoperative findings were a tumor located in the right adrenal gland, well delimited with irregular edges with lobulations.
Right adrenalectomy was performed without complications.
The postoperative evolution of the patient is favorable, remaining asymptomatic.
The pathologist informed the piece with a weight of 171.4 g, with dimensions of 9 x 8 x 6 cm, and the cut-off points with other areas - signs of hemorrhage and adipose tissue alternating with zones
Histopathological examination: myelolipoma of the adrenal gland with extensive areas of calcifications.
