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Case report
Adrenocortical neoplasm of uncertain malignant potential with a myelolipomatous component
  1. Adithya Balasubramanian1,
  2. Jason Scovell1,
  3. Adam E Dowell1,2 and
  4. Wesley Mayer1,2
  1. 1Baylor College of Medicine, Houston, Texas, USA
  2. 2Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Wesley Mayer; wesley.mayer{at}


Macroscopic fat inside an adrenal lesion on CT is pathognomonic for myelolipoma, a benign neoplasm. Without macroscopic fat, it can be difficult to discern the nature of an indeterminate adrenal mass on imaging. One possible diagnosis for an indeterminate lesion without macroscopic fat is an adrenal oncocytic neoplasm (AON). Despite its typical benign presentation cases of malignant AON have been reported. Patients with malignant AON are often not surgical candidates and survival for unresected disease is 20%–35%. We present the third report of an AON of uncertain malignant potential (AONUMP) associated with a macroscopic fatty component with the largest reported size and longest duration of follow-up in the literature. This report details diagnostic and therapeutic challenges posed by AONUMP. This case highlights how pathognomonic radiographical findings associated with benign myelolipoma might mask rare, potentially malignant, lipomatous tumours.

  • urological cancer
  • urology
  • urological surgery

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  • Contributors Category 1: Conception and design were performed by AB, JS, AED and WM. Acquisition of data and analysis an interpretation were done by AB, JS, AED and WM. Category 2: Drafting the manuscript was done by AB, JS, AED and WM. Category 3: Revising for intellectual content was performed by AB, JS, AED and WM. Category 4: Final approval of the completed manuscript was done by AB, JS, AED and WM.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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