MON-371 Giant Adrenal Myelolipoma: A Case Report

INTRODUCTION: Myelolipoma is a rare, benign tumor that primarily occurs in the adrenal gland. Through extensive review from different journal databases, there is only one case report published in the Philippines. CASE REPORT: A 48 year old Filipino female complained of left flank pain. She was normotensive, obese, with no Cushingoid features and had no history of weakness. CT scan with contrast showed a left 15cm adrenal mass with fatty component. Endocrine tests (excess of cortisol, catecholamines, and aldosterone) showed non functioning tumor with a normal DHEA-S. She underwent open adrenalectomy with an uneventful postoperative course. Initial histopathology was pheochromocytoma. Immunohistochemical staining revealed positive S100 expressing stromal fat cells and focal marrow precursor cell, LCA with expression of all mature leukocytes within the tumor, Melan-A showing residual adrenal glandular cells at the periphery of the tumor consistent with myelolipoma hence final diagnosis of adrenal myelolipoma. CONCLUSION: Adrenal myelolipomas present as large, hormonally inactive tumors with mass effects. Immunohistochemistry was important to confirm its diagnosis in this case.