{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:18Z","timestamp":1772168838587,"version":"3.50.1"},"reference-count":30,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T00:00:00Z","timestamp":1500336000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background<\/ns4:bold>\n                    : Adrenal incidentaloma refers to the incidental finding of a tumor in the adrenal gland, where nonfunctional forms are the most common variant. Myelolipoma is a rare (0.08-0.4%) occurrence characterized by adipose and hematopoietic tissue. The aim of this case report is to describe the diagnosis and appropriate management of a myelolipoma in an asymptomatic patient, which was originally considered an incidental hepatic hemangioma prior to being identified as a giant adrenal adenoma.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Case description:<\/ns4:bold>\n                    The patient was a 54 year old obese female with a recent diagnosis of diabetes type II and dyslipidemia with recent ultrasound imaging suggestive of a hepatic hemangioma. An MRI was performed revealing a 7x6cm lesion in the right adrenal area indicating a giant adrenal adenoma. An adrenalectomy was performed without complications. The pathology report identified a myelolipoma.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Discussion:<\/ns4:bold>\n                    The incidence of myelolipoma has recently increased due to advances in radiological techniques. Its etiology is unclear and the most accepted theories support a myeloid cell metaplasia in the embryonic stage as a result of stress, infections, or adrenocorticotropic hormone or erythropoietin stimulus. Contributing components may include bone morphogenetic protein 2 and\u00a0\u03b2-catenin, as well as the presence of the chromosomal translocation (3, 21) (q25; p11). Despite its benign nature, the association with other adrenal lipomas must be ruled out. A biochemical evaluation is essential for detecting subclinical states, such as Cushing syndrome and pheochromocytoma.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusion:<\/ns4:bold>\n                    Adrenal myelolipomas are rare benign tumors that are generally asymptomatic. Uncertainty still exists surrounding their etiology. Surgical management depends on hormone production, tumor size, high risk features on imaging and patient consent. \u00a0Additional information is needed to better understand myelolipomas, their etiology, and clinical management.\u00a0 Incidentalomas may confuse the physician and patient. Ensuring proper multidisciplinary management based on the clinical guidelines of endocrinology allowed a satisfactory resolution of this case.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.11766.1","type":"journal-article","created":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T12:05:04Z","timestamp":1500379504000},"page":"1140","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: An incidentaloma that catches your eye - adrenal 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adrenal incidentalomas: the role of medical imaging about two cases].","volume":"13","author":"Z Niki\u00e8ma","year":"2012","journal-title":"Pan Afr Med J."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"47-55","DOI":"10.12659\/PJR.889541","article-title":"Adrenal incidentaloma imaging - the first steps in therapeutic management.","volume":"78","author":"L Papierska","year":"2013","journal-title":"Pol J Radiol."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1186\/1471-2482-13-57","article-title":"Preoperative workup in the assessment of adrenal incidentalomas: outcome from 282 consecutive laparoscopic adrenalectomies.","volume":"13","author":"M Musella","year":"2013","journal-title":"BMC Surg."},{"key":"ref-4","first-page":"55-64","article-title":"Mesa 1: Incidentaloma Suprarrenal.","volume":"46","author":"R Chervin","year":"2009","journal-title":"Rev Argent Endocrinol Metab."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"516-30","DOI":"10.1016\/j.rx.2011.06.006","article-title":"[Diagnosis and management of adrenal incidentaloma].","volume":"53","author":"R Oliveira Caiafa","year":"2011","journal-title":"Radiologia."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"557-64","DOI":"10.3904\/kjim.2013.28.5.557","article-title":"Clinical characteristics and follow-up of Korean patients with adrenal incidentalomas.","volume":"28","author":"Y Cho","year":"2013","journal-title":"Korean J Intern Med."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"25-31","DOI":"10.4067\/S0718-40262012000100005","article-title":"Surgical management of adrenal incidentaloma.","volume":"64","author":"P Gac","year":"2012","journal-title":"Rev Chil Cir."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"352-354","DOI":"10.1590\/S0100-69912000000500014","article-title":"Giant adrenal incidentaloma in young patient.","volume":"27","author":"C Andrade","year":"2000","journal-title":"Rev Col Bras Cir."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"20-25","DOI":"10.3803\/EnM.2013.28.1.20","article-title":"Clinical Characteristics for 348 Patients with Adrenal Incidentaloma.","volume":"28","author":"J Kim","year":"2013","journal-title":"Endocrinol Metab (Seoul)."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"1-20","DOI":"10.4158\/EP.15.S1.1","article-title":"The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons medical guidelines for the management of adrenal incidentalomas.","volume":"15","author":"M Zeiger","year":"2009","journal-title":"Endocr Pract."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"130-3","DOI":"10.4103\/0974-7796.68865","article-title":"Giant adrenal myelolipoma: Incidentaloma with a rare incidental association.","volume":"2","author":"N Wani","year":"2010","journal-title":"Urol Ann."},{"key":"ref-12","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/789481","article-title":"Incidental detection of adrenal myelolipoma: a case report and review of literature.","volume":"2013","author":"J Nabi","year":"2013","journal-title":"Case Rep Urol."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"292-6","DOI":"10.4067\/S0718-40262012000300014","article-title":"Giant adrenal myelolipoma.","volume":"64","author":"P Gac","year":"2012","journal-title":"Rev Chi Cir."},{"key":"ref-14","first-page":"23-6","article-title":"Mielolipoma de gl\u00e1ndula suprarenal: Reporte de un caso.","volume":"28","author":"G Ben\u00edtez","year":"2005","journal-title":"RFM."},{"key":"ref-15","doi-asserted-by":"crossref","first-page":"880-3","DOI":"10.4321\/S0004-06142010001000010","article-title":"Mielolipoma suprarrenal: Aportaci\u00f3n de un caso y revisi\u00f3n de la literatura.","volume":"63","author":"L L\u00f3pez Mart\u00edn","year":"2010","journal-title":"Arch Esp Urol."},{"key":"ref-16","first-page":"254-9","article-title":"Myelolipoma, a rare surgical lesion of the adrenal gland.","volume":"51","author":"O Le\u00f3n Gonz\u00e1lez","year":"2012","journal-title":"Rev Cubana Cir."},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"911-3","DOI":"10.4321\/S0004-06142006000900012","article-title":"Giant right adrenal myelolipoma.","volume":"59","author":"M Castillo Lario","year":"2006","journal-title":"Arch Esp Urol."},{"key":"ref-18","doi-asserted-by":"publisher","first-page":"182-7","DOI":"10.1159\/000360981","article-title":"Giant Adrenal Myelolipoma Masquerading as Heart Failure.","volume":"7","author":"P Joy","year":"2014","journal-title":"Case Rep Oncol."},{"key":"ref-19","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/728198","article-title":"Giant Bilateral adrenal myelolipoma with congenital adrenal hyperplasia.","volume":"2014","author":"S Al-Bahri","year":"2014","journal-title":"Case Rep Sug."},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"236-8","DOI":"10.4103\/0971-9261.142019","article-title":"Adrenal myelolipoma: An incidental and rare benign tumor in children.","volume":"19","author":"S Barman","year":"2014","journal-title":"J Indian Assoc Pediatr Surg."},{"key":"ref-21","doi-asserted-by":"publisher","first-page":"E104-E107","DOI":"10.5489\/cuaj.1610","article-title":"Coordination of bone morphogenetic protein 2 (BMP2) and aberrant canonical Wnt\/\u03b2-catenin signaling for heterotopic bone formation in adrenal myelolipoma: A case report.","volume":"8","author":"Y Mitsui","year":"2014","journal-title":"Can Urol Assoc J."},{"key":"ref-22","doi-asserted-by":"publisher","first-page":"e678-9","DOI":"10.1200\/JCO.2010.30.2588","article-title":"Diagnosis of bilateral giant adrenal myelolipoma.","volume":"28","author":"D Ketelsen","year":"2010","journal-title":"J Clin Oncol."},{"key":"ref-23","doi-asserted-by":"crossref","first-page":"362-5","DOI":"10.4321\/S0004-06142005000400014","article-title":"[Giant adrenal myelolipoma].","volume":"58","author":"M Pareja Meg\u00eda","year":"2005","journal-title":"Arch Esp Urol."},{"key":"ref-24","doi-asserted-by":"publisher","first-page":"1018-20","DOI":"10.9738\/INTSURG-D-14-00128.1","article-title":"Giant Extra-Adrenal Retroperitoneal Myelolipoma With Incidental Gastric Mesenchymal Neoplasias.","volume":"100","author":"B Yildiz","year":"2015","journal-title":"Int Surg."},{"key":"ref-25","first-page":"342-4","article-title":"Adrenal myelolipoma in a young male - a rare case scenerio.","volume":"66","author":"M Anis-Ul-Islam","year":"2016","journal-title":"J Pak Med Assoc."},{"key":"ref-26","first-page":"249-50","article-title":"[Giant adrenal myelolipoma. Right laparoscopic adrenalectomy].","volume":"76","author":"A Campos Arbul\u00fa","year":"2016","journal-title":"Medicina (B Aires)."},{"key":"ref-27","doi-asserted-by":"publisher","first-page":"E637-40","DOI":"10.5489\/cuaj.422","article-title":"Pathologic analysis, diagnosis and treatment of adrenal myelolipoma.","volume":"8","author":"H Su","year":"2014","journal-title":"Can Urol Assoc J."},{"key":"ref-28","doi-asserted-by":"publisher","first-page":"494-6","DOI":"10.1016\/j.ijscr.2014.04.001","article-title":"Adrenal myelolipoma: To operate or not? A case report and review of the literature.","volume":"5","author":"M Ramirez","year":"2014","journal-title":"Int J Surg Case Rep."},{"key":"ref-29","doi-asserted-by":"publisher","first-page":"192-4","DOI":"10.1016\/j.ijscr.2012.09.014","article-title":"Adrenal incidentaloma does it require surgical treatment? Case report and review of literature.","volume":"4","author":"G Yalagachin","year":"2013","journal-title":"Int J Surg Case Rep."},{"key":"ref-30","first-page":"341-50","article-title":"[A study of 34 cases of adrenal incidentaloma.]","volume":"67","author":"R Chervin","year":"2007","journal-title":"Medicina (B Aires)."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T09:06:20Z","timestamp":1544087180000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,18]]},"references-count":30,"URL":"https:\/\/doi.org\/10.12688\/f1000research.11766.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.12710.r24335","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12710.r24338","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12710.r24335","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.12710.r24338","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,18]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.12710.r24338, Jos\u00e9 Manuel Ram\u00edrez Aranda, Jes\u00fas Zacar\u00edas Villarreal- Perez, School of Medicine, Family Medicine Department, Autonomous University of Nuevo Leon, Monterrey, Mexico, 25 Jul 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1#referee-response-24338","order":0,"name":"referee-response-24338","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.12710.r24335, Ana Nunes Barata, ACES Amadora, UCSP Buraca , Lisbon, Portugal, 31 Jul 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1#referee-response-24335","order":1,"name":"referee-response-24335","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Tanja Pekez-Pavlisko<\/b>; \n<i>Posted: 30 Jul 2017<\/i>; I think that article is very good written. Case is very well documented. This case can be helpful to other physicians. Question one: do we need such a number of investigations (mentioned in the discussion) regarding so rare tumor. Question two: is it necessary so aggressive hypolipemic therapy. Question three: do we need as a family doctor and does patient need lab tests regarding insulin?","URL":"https:\/\/f1000research.com\/articles\/6-1140\/v1#article-response-2923","order":2,"name":"article-response-2923","label":"Article Comment","group":{"name":"article-comments","label":"Article Comments"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}