ADRENAL MYELOLIPOMA EMBEDDED IN THE LIVER MIMICKING HEPATOCELLULAR CARCINOMA WITH FATTY DEGENERATION

REPORT OF A CASE

Abstract

A 46-year-old male patient complaining of upper abdominal pain and diarrhea underwent echographic examination of the abdomen and it incidentally disclosed a mass lesion in the lower portion of right lobe of the liver. He was referred to our hospital for further examination and treatment. Echography at admission revealed a round and smooth-surfaced mass, 4cm in diameter, in the posterior segment of the right lobe and a CT scan confirmed the low density mass with fine reticular structure which was not enhanced on contrast CT. From these findings hepatocellular carcinoma with fatty degeneration was most suspected and surgical treatment was scheduled. But on the day before operation he developed marked hypotension and shock. Fortunately, he recovered from such serious conditions with supportive reatments and posterior segmentectomy of the liver was electively carried out. The tumor, measuring 4.5×4.5×3cm, was embedded in the posterior segment and wellcircumscribed from the surrounding liver parenchyma. Histological diagnosis of the tumor was an adrenal myelolipoma embedded in the liver. We reviewed the literature on the adrenal myelolipoma.