Very rare giant adrenal myelolipoma: a tumor mimic

Adrenal myelolipoma is very rare and non-functional, benign tumor, predominantly occurs in the adrenal gland. and composed of varying amounts of macroscopic adipose tissues and mature hematopoietic elements, resembling bone marrow. It effects men and female equally mostly during 5 to 7 decade of life. Incidental detection is most common. Exact incidence of these tumors not known where as some studies have found out the incidence to be 0.008-0.4%. It has been seen the size of these tumors can vary from as small as 4 cm to as large as 31 cm till date. The small size (usually <4 cm) are asymptomatic hence treated conservatively. Surgical management is recommended when becomes symptomatic, or grows quickly or to attain a size of >6 cm. In case of malignant or potentially malignant tumors, adrenalectomy must be performed. Giant myelolipoma is when its greatest diameter attains >10 cm. Most often the right adrenal gland is the origin, but other sites, such as the presacral area, spleen, stomach, lung, liver, retroperitoneum and testis, are also reported. Here we discuss about a case of incidental diagnosis of adrenal myelolipoma in a 59 year old male who presented with pain abdominal pain diagnosis, review the literature and management.