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Case Report Open Access

Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature

  • Authors:
    • Giovanni Cochetti
    • Alessio Paladini
    • Andrea Boni
    • Elisa Silvi
    • Alberto Tiezzi
    • Jacopo Adolfo Rossi de Vermandois
    • Ettore Mearini
  • View Affiliations / Copyright

    Affiliations: Department of Surgical and Biomedical Sciences, Inter-Divisional Urology Clinic (Perugia-Terni), Santa Maria della Misericordia University Hospital, I-06156 Perugia, Italy
    Copyright: © Cochetti et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 492-496
    |
    Published online on: March 12, 2019
       https://doi.org/10.3892/mco.2019.1823
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Abstract

Adrenal myelolipoma is a rare mesenchymal tumour with benign biological behaviour that is mainly composed of mature adipose and myeloid tissue. Both sexes are equally affected, most commonly between the fifth and seventh decades of life. The diagnosis of adrenal myelolipoma is mostly incidental. Although it may occasionally be associated with necrosis, rupture and haemorrhage, causing abdominal pain, this tumour is usually asymptomatic. Consequently, management is conservative, while surgical treatment is reserved for symptomatic cases, or for masses growing quickly or to a size >6 cm. Giant myelolipomas (sized >10 cm) are rare. Open radical adrenalectomy is the standard treatment for giant myelolipomas, while the minimally invasive approach has been used in only few cases. We herein report the case of a patient with a giant adrenal myelolipoma who underwent robotic partial adrenalectomy. To the best of our knowledge, this is the largest giant adrenal myelolipoma treated with robotic surgery reported in the literature to date. A 55‑year‑old male patient underwent an abdominal computed tomography scan during follow‑up after radical prostatectomy for prostate cancer Gleason Score 6 (ISUP 1) due to biochemical recurrence. The examination revealed a right hypodense adrenal mass, sized 16x13 cm. Abdominal magnetic resonance imaging confirmed the presence of characteristics suggestive of a myelolipoma. The patient did not report any symptoms. Due to the benign characteristics of the mass, robotic partial adrenalectomy and enucleation of the mass were performed. The operative time and estimated blood loss were 205 min and 100 ml, respectively. No intra‑ or postoperative complications occurred. The patient was mobilized on the first postoperative day and the time to flatus was 36 h; the length of hospitalization was 4 days. Histological examination confirmed the diagnosis of adrenal myelolipoma, sized 18x11.5x6 cm. No tumour recurrence occurred over a follow‑up period of 12 months. In conclusion, robotic surgery allows performing partial adrenalectomy with a lower risk of bleeding and with preservation of healthy adrenal tissue, which is of paramount importance for the patient as it reduces recovery time and the need for medical substitution therapy.
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Copy and paste a formatted citation
Spandidos Publications style
Cochetti G, Paladini A, Boni A, Silvi E, Tiezzi A, Rossi de Vermandois JA and Mearini E: Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature. Mol Clin Oncol 10: 492-496, 2019.
APA
Cochetti, G., Paladini, A., Boni, A., Silvi, E., Tiezzi, A., Rossi de Vermandois, J.A., & Mearini, E. (2019). Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature. Molecular and Clinical Oncology, 10, 492-496. https://doi.org/10.3892/mco.2019.1823
MLA
Cochetti, G., Paladini, A., Boni, A., Silvi, E., Tiezzi, A., Rossi de Vermandois, J. A., Mearini, E."Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature". Molecular and Clinical Oncology 10.5 (2019): 492-496.
Chicago
Cochetti, G., Paladini, A., Boni, A., Silvi, E., Tiezzi, A., Rossi de Vermandois, J. A., Mearini, E."Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature". Molecular and Clinical Oncology 10, no. 5 (2019): 492-496. https://doi.org/10.3892/mco.2019.1823
Copy and paste a formatted citation
x
Spandidos Publications style
Cochetti G, Paladini A, Boni A, Silvi E, Tiezzi A, Rossi de Vermandois JA and Mearini E: Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature. Mol Clin Oncol 10: 492-496, 2019.
APA
Cochetti, G., Paladini, A., Boni, A., Silvi, E., Tiezzi, A., Rossi de Vermandois, J.A., & Mearini, E. (2019). Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature. Molecular and Clinical Oncology, 10, 492-496. https://doi.org/10.3892/mco.2019.1823
MLA
Cochetti, G., Paladini, A., Boni, A., Silvi, E., Tiezzi, A., Rossi de Vermandois, J. A., Mearini, E."Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature". Molecular and Clinical Oncology 10.5 (2019): 492-496.
Chicago
Cochetti, G., Paladini, A., Boni, A., Silvi, E., Tiezzi, A., Rossi de Vermandois, J. A., Mearini, E."Robotic treatment of giant adrenal myelolipoma: A case report and review of the literature". Molecular and Clinical Oncology 10, no. 5 (2019): 492-496. https://doi.org/10.3892/mco.2019.1823
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