Extramedullary Hematopoiesis Mimicking as an Adrenal Incidentaloma: A Case Report
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Abstract
We report on a case of extramedullary hematopoiesis in a male in his 50s who presented with right adrenal incidentaloma from CT scan for right ureteric calculi. The patient denied having any symptoms of mass effect or functioning of adrenal tumor. The CT scan revealed a heterogeneous fatty density mass with minimal enhancement in the right adrenal region, measuring 9.9 x 8.8 x 10.7 cm. Open adrenalectomy was performed after exclusion of a functioning tumor. The pathology report confirmed massive extramedullary hematopoiesis in the fat tissue surrounding the normal adrenal gland. A hematologist was consulted to assess the cause of extramedullary hematopoiesis in this case, and no abnormal hematologic cause was found. This case highlights the need to consider extramedullary hematopoiesis as a rare differential diagnosis for adrenal masses, even in the absence of hematologic abnormalities, to guide accurate diagnosis and management.
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References
Lau HY, Lui DCY, Ma JKF, Wong RWC. Sonographic features of adrenal extramedullary hematopoiesis. J Ultrasound Med 2011;30:706-7.
Kamran H, Haghpanah A, Dabbaghmanesh MH, Defidio L, Bazrafkan M, Dehghani A, et al. Simultaneous adrenal and retroperitoneal myelolipoma resected by laparoscopic surgery: a challenging case. BMC Urol 2023;23(1):114
Decmann Á, Perge P, Tóth M, Igaz P. Adrenal myelolipoma: a comprehensive review. Endocrine 2018;59(1):7-15.
Fassnacht M, Tsagarakis S, Terzolo M, Tabarin A, Sahdev A, Newell-Price J, et al. European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2023;189(1):G1-G42.
Calissendorff J, Juhlin CC, Sundin A, Bancos I, Falhammar H. Adrenal myelolipomas. Lancet Diabetes Endocrinol 2021;9(11):767-75.
Young WF. Clinical practice. The incidentally discovered adrenal mass. N Engl J Med 2007;356:601-10.
O'Regan KN, Jagannathan J, Krajewski K, Zukotynski K, Souza F, Wagner A, et al. Imaging of liposarcoma: classification, patterns of tumor recurrence, and response to treatment. AJR Am J Roentgenol 2011;197(01):W37-43.
Lam AK. Update on adrenal tumours in 2017 World Health Organization (WHO) of endocrine tumours. Endocr Pathol 2017;28(3):213-27.
Esfandbod M, Kabootari M. Adrenal extramedullary hematopoiesis: a case report. J Clin Case Reports 2012;2(16):1000226.
Ebbehoj A, Li D, Kaur RJ, Zhang C, Singh S, Li T, et al. Epidemiology of adrenal tumours in Olmsted County, Minnesota, USA: a population-based cohort study. Lancet Diabetes Endocrinol 2020;8(11):894-902.
Jing Y, Hu J, Luo R, Mao Y, Luo Z, Yang J, et al. Prevalence and characteristics of adrenal tumors in an unselected screening population: a cross-sectional study. Ann Intern Med 2022;175(10):1383-91.
Hamidi O, Raman R, Lazik N, Iniguez-Ariza N, McKenzie TJ, Lyden ML, et al. Clinical course of adrenal myelolipoma: a long-term longitudinal follow-up study. Clin Endocrinol (Oxf) 2020;93(1):11-8.
