Bilateral adrenal myelolipomas with Cushing's syndrome
H. A. Kanj, J. Noronha, A. F. D'Aguillo, J. K. Amorosa and L. F. Amorosa
Department of Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
A 24-year-old woman with non-pituitary dependent Cushing's syndrome was
found to have bilateral adrenal myelolipomas at surgery. These benign
tumors consist of bone marrow and fat and are uncommon incidental findings
that are discovered by computed tomography. Myelolipomas have rarely been
associated with Cushing's syndrome, but the cause of the syndrome has not
always been defined, because the reports preceded modern diagnostic
methods. Careful examination of the adrenal glands from our patient showed
a fusion of myelolipoma elements and adrenal cells without distinct
adenomas or the typical nodular pattern of adrenal hyperplasia. This report
suggests that adrenal myelolipomas and atypical hyperplasia of the zona
fasciculata may be anatomically and functionally related.
