%0 Journal Article
%T Mielolipoma, una lesi¨®n quir¨²rgica poco frecuente de la gl¨¢ndula adrenal Myelolipoma, an infrequent surgical lesion of the adrenal gland
%A Humberto ¨¢lvarez-Pertuz
%A Laura Arroyo-Mart¨ªnez
%A Jorge Acu£¿a-Calvo
%J Acta M¨¦dica Costarricense
%D 2008
%I Colegio de M¨¦dicos y Cirujanos de Costa Rica
%X El mielolipoma es un tumor benigno poco frecuente, compuesto de tejido adiposo maduro y elementos hematopoy¨¦ticos diversos, histol¨®gicamente similares a la m¨¦dula ¨®sea normal. Estos tumores se pueden localizar com¨²nmente en las gl¨¢ndulas adrenales, pero tambi¨¦n en sitios extra adrenales. Puede encontrarse como tumor ¨²nico o m¨²ltiple, y es hormonalmente inactivo.1 El origen del mielolipoma es desconocido y se han propuesto varias teor¨ªas. Los mielolipomas muestran una gran variedad de manifestaciones cl¨ªnicas, tales como: sangrado digestivo, hematuria, dolor abdominal en los flancos, masa abdominal y p¨¦rdida de peso, entre otras. La incidencia de estos tumores en autopsias es del 0,08 al 0,2 %, gracias al US, la TAC y la RM, su hallazgo es mas frecuente hoy.2 El diagn¨®stico es generalmente por exclusi¨®n, habi¨¦ndose descartado otras entidades suprarrenales. Entre los m¨¦todos diagn¨®sticos figuran: la TAC, el US y la RM. La resecci¨®n quir¨²rgica es el tratamiento de elecci¨®n, cuando haya sintomatolog¨ªa; de lo contrario, un manejo conservador con controles peri¨®dicos del paciente ser¨¢ m¨¢s que suficiente.3 Se presenta el caso de una paciente de 55 a os, hipertensa, obesa y con un trastorno depresivo-ansioso, quien consult¨® por dolor abdominal, n¨¢useas y v¨®mitos. Myelolipoma is a non functioning benign tumor of the adrenal gland which is formed by hematopoietic and adipose tissue. The tumor was first described by Gierke in 1905, and named by Oberling in 1929. Most series consist of myelolipomas discovered incidentally at autopsy. They are generally located in the adrenal gland, although they can occur in other organs. Endocrine and/or metabolic disorders associated with AML include obesity, Type II Diabetes, congenital adrenal hyperplasia due to 21 or 17 alpha-hydroxylase deficiency, Cushing¡¯s disease, Conn¡¯s syndrome, pheochromocytoma and polycystic ovarian disease. Myelolipomas are asymptomatic, but they may cause pain secondary to bleeding, hematuria or mass; when symptomatic, the most consistent complaint is abdominal pain caused by hemonhage within the tumor. Ultrasound combined with computed tomography is useful in diagnosis. Definitive diagnosis and treatment are accomplished by simple excision and histological repon; radical surgery is unneceSSary. We present here the case of a 55 years oId female who came in with abdominal pain, nausea and vomiting. After an abdominal ultrasound, an abdominal CI scan and eventually, surgical removal, an adrenal myelolipoma was found. She did well after surgery and remains asymptornatic.
%K mielolipoma
%K sangrado digestivo
%K gl¨¢ndula adrenal
%K tumor benigno
%K tejido hematopoy¨¦tico
%K laparotom¨ªa exploratoria
%K myelolipoma
%K G.1 bleeding
%K adrenal gland
%K bening tumor
%K hematopoietic tissue
%K exploratory laparotomy
%U http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S0001-60022008000100011