腎上腺骨髓性脂肪瘤冷凍治療罕見案例分享

江衍諭¹、余燦榮^1、2、吳俊賢^1、2、林嘉祥^1、2

¹義大醫療財團法人義大醫院 泌尿科；²義守大學 醫學系

A rare case of adrenal myelolipoma underwent cryotherapy

Yen-Yu Chiang ¹,Tsan Jung Yu^1,2, Victor C. Lin^1,2, Chun-Hsien Wu ^1,2

Department of Urology¹, E-Da Hospital, Kaohsiung, Taiwan;

School of Medicine, College of Medicine², I-Shou University, Kaohsiung, Taiwan

Introduction:

Adrenal myelolipoma is a rare, benign tumor composed of mature adipose tissue and hematopoietic elements, often diagnosed incidentally due to advances in imaging modalities. While usually asymptomatic and small, lesions exceeding 4–5 cm carry a risk of hemorrhage, posing management challenges.

Case Description:

A 55-year-old female was incidentally found to have a 5.5 cm right adrenal mass during routine ultrasound examination. Computed Tomography imaging demonstrated a fat-containing lesion consistent with myelolipoma. Comprehensive hormonal evaluation excluded functional adrenal pathology. Due to lesion size and hemorrhagic risk, image-guided cryotherapy ablation was performed. Histopathological analysis confirmed the diagnosis, revealing mature adipose tissue admixed with hematopoietic cells. The patient experienced no complications and was discharged the next day. Follow-up showed no recurrence or symptoms.

Discussion:

Adrenal myelolipomas account for a small proportion of adrenal incidentalomas but are increasingly detected with widespread imaging. Diagnosis relies on characteristic imaging features and biochemical exclusion of functional tumors. Management is individualized; asymptomatic small tumors generally undergo observation, and large or symptomatic lesions warrant intervention. Minimally invasive ablative procedures, such as cryotherapy, represent safe and effective alternatives to surgical resection in selected patients.

Conclusion:

This case highlights the successful use of image-guided cryotherapy ablation for a large asymptomatic adrenal myelolipoma, emphasizing the importance of individualized treatment strategies balancing tumor size, clinical risk, and patient condition. Minimally invasive therapies should be considered alongside traditional surgical options.