ABSTRACT
Myelolipoma is a benign adrenocortical neoplasm comprising myeloid and adipose tissues. The incidence of myelolipoma has increased in recent times owing to the widespread use of imaging modalities including computed tomography (CT) and magnetic resonance imaging (MRI). Myelolipoma is the second-most common primary adrenal incidentaloma. Invariably, myelolipomas are biochemically nonfunctional. Majority of them are asymptomatic and silent. However, patients may present with abdominal discomfort, pain in the abdomen, lumbar regions, loins or back, vague symptoms of dyspepsia and upper gastrointestinal symptoms. On contrast-enhanced abdominal tomography, attenuation values of −90 to −120 HU are diagnostic. For cases of asymptomatic myelolipoma, follow-up with serial imaging should be adequate, given that the tumor is benign, slow-growing and inert in nature. Symptomatic myelolipomas need to be treated by surgery.
