000			02292nam a22003017a 4500
008			201229s20142014 xxu||||| |||| 00| 0 eng d
040			_aOvid MEDLINE(R)
099			_a25140269
245			_aGiant bilateral adrenal myelolipoma with congenital adrenal hyperplasia.
251			_aCase Reports in Surgery. 2014:728198, 2014.
252			_aCase Rep Surg. 2014:728198, 2014.
253			_aCase reports in surgery
260			_c2014
260			_fFY2014
265			_sppublish
266			_d2020-12-29
520			_aMyelolipomas are rare and benign neoplasms, predominant of the adrenal glands, consisting of adipose and mature hematopoietic tissue, commonly discovered incidentally with increased use of radiologic imaging. Few cases of giant bilateral adrenal masses are reported, especially in the setting of congenital adrenal hyperplasia (CAH). We report the case of a 39-year-old male with a history of CAH secondary to 21-alpha hydroxylase deficiency on steroids since childhood, self-discontinued during adolescence, presenting with abdominal distension, fatigue, decreased libido, and easy bruising. Imaging revealed giant bilateral adrenal masses. He subsequently underwent bilateral adrenalectomy found to be myelolipomas measuring 30 x 25 x 20 cm on the left and weighing 4.1 kg and 25 x 20 x 13 cm on the right and weighing 2.7 kg. Adrenal myelolipomas are found to coexist with many other conditions such as Cushing's syndrome, Addison's disease, and CAH. We discuss the association with high adrenocorticotropic hormone (ACTH) states and review the studies involving ACTH as proponent leading to myelolipomas. Massive growth of these tumors, as in our case, can produce compression and hemorrhagic symptoms. We believe it is possible that self-discontinuation of steroids, in the setting of CAH, may have resulted in the growth of his adrenal masses.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Union Memorial Hospital
657			_aJournal Article
700			_aAl-Bahri, S
700			_aLowentritt, B
700			_aNasrallah, D V
790			_aAl-Bahri S, Lowentritt B, Nasrallah DV, Tariq A
856			_uhttps://dx.doi.org/10.1155/2014/728198 _zhttps://dx.doi.org/10.1155/2014/728198
942			_cART _dArticle
999			_c5771 _d5771