Endocrine Abstracts

Introduction: Adrenal myelolipoma is an extremely rare benign adrenal tumor. Adrenal myelolipoma is characterized by the presence within the adrenal gland of mature adipose tissue and active bone marrow elements. Owing to their non-functional nature most cases are incidental, either at autopsy or through computer tomography scan. Occasionally the lesions attain a large size to become clinically apparent. Seropositive rheumatoid arthritis is a disorder affecting approximately 1% of the population.

Aim: The aim was to describe the case of a patient with an adrenal myelolipoma who later developed seropositive rheumatoid arthritis.

Case report: A male patient, aged 42, presented with bilateral symmetric polyarthitis affecting the small joints of the hands, knees and shoulders. He had morning stiffness lasting >1 h. Rheumatoid factor was positive and anti-CCP antibodies were positive. The patient had a history of an adrenal myelolipoma, which was discovered incidentally at the age of 31 and was removed surgically. The patient underwent further evaluation for polyarthritis and the diagnosis of rheumatoid arthritis was made. Methotrexate was administered in a weekly regimen.

Conclusion: Adrenal myelolipoma is a rare benign tumor of the adrenal. Many cases do not require surgical treatment. In the case described, myelolipoma was surgically removed, the patient later incidentally developing severe seropositive rheumatoid arthritis.

Reference Luo J. et al. Lipoadenoma of the adrenal gland: report of a rare entity and review of literature. Int J Clin Exp Pathol 2015; 8:9693–7.