Sonographic appearance of myelolipoma: Demonstration of adrenal and pelvic lesions

✍ Scribed by Edward I. Miller; Russell W. Dickerson

• Publisher: John Wiley and Sons
• Year: 1983
• Tongue: English
• Weight: 254 KB
• Volume: 11
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870110306

✦ Synopsis

Myelolipoma is an uncommon tumor composed of varying amounts of fat and bone marrow elements. Most cases reported until recently were discovered incidentally at autopsy. With the advent of ultrasound and computed tomography (CT), the tumor is being more frequently recognized preoperatively. The imaging characteristics of marked hyperechogenicity on ultrasound examination and fat density on CT allow a presumptive preoperative diagnosis in the adrenal gland area, where the mass is usually located. Very rarely, myelolipoma may appear in the pelvis, where it may appear similar on ultrasound to a solid gynecological mass or pelvic sarcoma.

Two patients, one with adrenal myelolipoma, the other with presacral myelolipoma are presented.

CASE REPORTS

Case 1

A 53-yr-old woman was admitted to Hoag Memorial Hospital with a complaint of left flank pain, high blood pressure, and a previous history of ulcer disease and diverticulitis. An abdominal sonogram revealed a mass (Fig 1) in the right adrenal region which was highly echogenic. An intravenous pyelogram taken one week prior to admission was reviewed. In retrospect, increased lucency was noted above the right kidney. A computed tomogram study (Fig 2) confirmed a lowdensity lesion of -50 Hounsfield units. In view of recent reports of the hyperechogenic character of myelolipomas,',2 a presumptive diagnosis of that lesion was made. At surgery an 8.0 x 7.5 X 5.5cm, well-circumscribed, unencapsulated tumor From the Division of Ultrasound, Department of Radiology,