副腎Myelolipomaの1例

Abstract

We report a case of adrenal myelolipoma occurring in a 56-year-old man. The patient complained of lumbago and gross hematuria in October, 1981 and consulted a local doctor who pointed out a right ureteral stone and downward deviation of the left kidney. The patient was referred to our hospital for further examination. An echogram showed a high echogenic mass in the left flank which was compressing the spleen and the kidney. A CT scan revealed a large mass with heterogeneous low density contents. The mass was lobulated into several parts and their density suggested fat tissue. An aortogram showed an avascular mass and an adrenal venogram showed multiple veins which radiated to the periphery. Judging from these findings, a tentative diagnosis of adrenal myelolipoma was made and left adrenalectomy was performed. Histological examination revealed that this tumor was composed of adrenal tissues, fatty tissues and myeloid tissues. The postoperative course was uneventful. We discuss the necessity of aortography and selective adrenal venography to evaluate the origin of the tumor. To our knowledge, this is the tenth case report of adrenal myelolipoma in Japan and we have made a brief review of Japanese literature of adrenal myelolipoma.