A CASE OF ADRENAL MYELOLIPOMA ASSOCIATED WITH MASSIVE BLEEDING

Adrenal myelolipomas are usually asymptomatic. With an enlargement of the tumor lumbago and other symptoms due to pressure from enlarging tumor on the organ come out. Rupture of bleeding has been rarely reported on. Here a case of adrenal myelolipoma associated with massive retroperitoneal bleeding is presented. A 46-year-old man was sent to the hospital by ambulance because of shock state. Abdominal ultrasonography and computed tomography demonstrated the presence of retroperitoneal masses with massive hematoma in the posterior region of It-kidney. Then emergency operation was carried out. During surgery two retroperitoneal and one left adrenal tumors were recognized which were 25.0×15.0×15.0cm (3200g), 2.5×2.0×1.5cm, and 5.0×5.0×2.0cm, respectively. Histopathologically all tumors were adrenal myelolipoma and in the main tumor inner massive hemorrage was seen. Adrenal myelolipoma has been reported in about 50 cases in Japan so far. Almost of these reported cases were diagnosed incidentally by abdominal echography or CT. Inner hemorrhage case with hypovolemic shock like our case is very rare.