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Giant secretory multifocal adrenal myelolipoma: a diagnostic dilemma
  1. Brijesh Kumar Singh1,
  2. Prasanna Ramana Arumugaswamy1,
  3. Sunil Chumber2 and
  4. Yashwant Singh Rathore1
  1. 1Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
  2. 2Head of Department, Department of Surgical Discipline, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Yashwant Singh Rathore; dryashvant.r{at}


A 38-yearr-old man presented with erectile dysfunction and infertility. On examination, he was hypertensive and detected to have a left flank mass. Blood investigations were unremarkable except raised serum noradrenaline levels. Imaging revealed multiple well-defined fat-containing hypodense lesions in left suprarenal area with largest one measuring 14×16 cm, suggestive of left adrenal myelolipoma. Diagnostic dilemma was posed due to discordance between clinical, biochemical and imaging findings. Left adrenal mass resection was planned keeping the possibility of pheochromocytoma. However, histopathology revealed it to be adrenal myelolipoma. Hypertension was resolved in the postoperative period and serum noradrenaline levels were normalised. Final diagnosis of a secretary adrenal myelolipoma was made, which is an extremely rare entity

  • adrenal disorders
  • endocrine cancer

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  • Contributors BKS diagnosed and managed the case, drafted the initial manuscript. YSR and PRA managed the case, prepared the clinical photographs and critically revised the manuscript. SC finalised the manuscript and all the authors approved the final manuscript.

  • 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.