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Giant bilateral adrenal myelolipoma with congenital adrenal hyperplasia.
[congenital adrenal hyperplasia]
Myelolipomas
are
rare
and
benign
neoplasms
,
predominant
of
the
adrenal
glands
,
consisting
of
adipose
and
mature
hematopoietic
tissue
,
commonly
discovered
incidentally
with
increased
use
of
radiologic
imaging
.
Few
cases
of
giant
bilateral
adrenal
masses
are
reported
,
especially
in
the
setting
of
congenital
adrenal
hyperplasia
(
CAH
)
.
We
report
the
case
of
a
39
-
year
-old
male
with
a
history
of
CAH
secondary
to
21
-
α
hydroxylase
deficiency
on
steroids
since
childhood
,
self-discontinued
during
adolescence
,
presenting
with
abdominal
distension
,
fatigue
,
decreased
libido
,
and
easy
bruising
.
Imaging
revealed
giant
bilateral
adrenal
masses
.
He
subsequently
underwent
bilateral
adrenalectomy
found
to
be
myelolipomas
measuring
30
×
25
×
20
 
cm
on
the
left
and
weighing
4
.
1
 
kg
and
25
×
20
×
13
 
cm
on
the
right
and
weighing
2
.
7
 
kg
.
Adrenal
myelolipomas
are
found
to
coexist
with
many
other
conditions
such
as
Cushing
's
syndrome
,
Addison
's
disease
,
and
CAH
.
We
discuss
the
association
with
high
adrenocorticotropic
hormone
(
ACTH
)
states
and
review
the
studies
involving
ACTH
as
proponent
leading
to
myelolipomas
.
Massive
growth
of
these
tumors
,
as
in
our
case
,
can
produce
compression
and
hemorrhagic
symptoms
.
We
believe
it
is
possible
that
self-discontinuation
of
steroids
,
in
the
setting
of
CAH
,
may
have
resulted
in
the
growth
of
his
adrenal
masses
.
Diseases
Validation
Diseases presenting
"easy bruising"
symptom
congenital adrenal hyperplasia
This symptom has already been validated
