Do Giant Adrenal Myelolipomas Behave Differently? A Clinicopathological Comparative Study

ABSTRACT Adrenal myelolipomas (AM) may present with abdominal distension, pain, rupture, hemorrhage or other complications. Indications for surgery are still debatable. It is possible that larger size may be a risk factor for symptoms or complications in AM. To compare the clinical and pathological characteristics between giant AM (>10 cm) and AM <10 cm. Retrospective data analysis was done on 26 of 32 patients with myelolipoma who underwent surgery between January, 2005 and July, 2012. Patients were divided in two groups: Group 1 (n = 14) with giant AM > 10 cm and group 2 (n = 12) AM < 10 cm. Results were analyzed using independent sample t-test (SPSS v.17). Twenty-six myelolipomas managed surgically were identified from 338 adrenal tumors. None were functioning on biochemical evaluation. Comparing group 1 vs 2, the differences noted were: Commonest age group at presentation was 4th decade vs 5th decade, clinical presentation with abdominal pain was 11 vs 7 (p = 0.05), surgical approach was open in 11 vs 6, and laparoscopic in 3 vs 6 (p = 0.03), mean tumor size was 15.57 vs 6.67 cm, mean tumor weight 794 vs 93 gm, internal hemorrhage on histopathology in 14 vs 10 (p = 0.05). Giant AM have a significantly higher rate of symptomatic presentation, pathological features of hemorrhage and necrosis and requirement for open surgery as compared to myelolipomas <10 cm in our series. How to cite this article Ramakant P, Mukha R, Cherian AJ, Naik D, Paul TV, Abraham DT, Paul MJ. Do Giant Adrenal Myelolipomas Behave Differently? A Clinicopathological Comparative Study. World J Endoc Surg 2013;5(1):12-15.