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Cirujano general

versão impressa ISSN 1405-0099

Resumo

BAUTISTA OLAYO, Roberto et al. Adrenal Incidentalomas: A case of Myelolipoma. Cir. gen [online]. 2014, vol.36, n.4, pp.239-244. ISSN 1405-0099.

Introduction: A tumor in the adrenal gland from studies performed for an unrelated indication they are known as "incidentalomas". Are rare lesions that can be found in up to 4% of young people, but up to 10% of patients between the fi fth and seventh decade of life. The advent of modern diagnostic imaging methods such as computed tomography and magnetic resonance imaging have signifi cantly increased their diagnosis and becoming increasingly common face them. The spectrum on the type of injury is extensive. They can be: benign, malignant, or not functional injuries and their fi nding undertakes to perform a diagnostic protocol seeking to establish their nature and defi ne a treatment plan that can be surgical or not.

Case report: We report the case of a 60 year old in our service attended by nonspecifi c pain in right hipocrondrio compatible with biliary colic, before the discovery in ultrasonography (completed with a suspected abdominal CT and liver tumor) of a dependent injury right adrenal gland. After the diagnosis and by the characteristics of the lesion protocol, resection of a cystic tumor complex of 15 × 13 × 10 cm depending on the right adrenal gland, histopathological analysis was performed which corresponded to adrenal Myelolipoma. The postoperative course of the patient was favorable, he graduated the third day and remained asymptomatic at the time of this report.

Conclusion: Incidentalomas are injuries to surgeons facing today more frequently due to the availability of better diagnostic imaging resources. Before his discovery, we perform a complete evaluation protocol to establish the nature of the injury. Surgery is indicated in all cases where malignancy is suspected or those considered benign, symptoms occur, whether large tumors (>4 cm) or secretory, and when the tumor during follow present changes in their characteristics could be associated with greater complications as malignant or bleeding. If the conditions of the tumor and the surgeon's experience allow, the laparoscopic approach will be the first choice.

Palavras-chave : Glandula suprarrenal; Mielolipoma.

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