Adrenal Myelolipomas Case Series

Adrenal Myelolipomas Case Series Laparoscopic Management

Six cases (72 years old female patient, 63 years old male patient, 57 years old female patient, 61 years old female, 72 years old female and 56 years old female) of clinically and radiologically suspected cases of symptomatic adrenal myelolipoma are discussed here. All cases described, presented with flank pain radiating which was suspected as adrenal mass by Computed Tomography (CT) evaluation. All six cases were histopathologically confirmed as adrenal myelolipoma and managed by laparoscopic surgical excision.

Study Overview

• Status: Completed
• Conditions: Adrenal Myelolipoma

Detailed Description

The management in all cases was by laparoscopic adrenalectomy with transperitoneal approach. Several retrospective and comparative studies addressed the advantage of minimally invasive adrenalectomy specifically consistent in less postoperative pain, improved patients' satisfaction, shorter hospital stay and recovery time when compared to open adrenalectomy.

The laparoscopic transabdominal lateral adrenalectomy is currently the most widely used approach.

All our cases were managed by this technique. In our cases initial peritoneal access is achieved 2cm inferior to the right/left costal margin in the midclavicular line, a pressure of 15mmHg is used for CO2 insufflation. Optical access 10-12mm trocar for the endoscope is placed in the pararectal line 5cm above the umbilicus. Under direct vision, the second 10- 12 mm trocar is placed medially to the first one. The third trocar (5mm) is inserted 3 cm above the anterior superior iliac spine in the anterior axillary line. The fourth trocar (5mm) is inserted at the subcostal angle. The key factor for an adequate exposure is an effective dissection of the Toldt fascia. Vascular structures are ligated with Hem-O-Lock and subsequent dissection of the adrenal gland with ultrasonic energy. The adrenal is extracted through a Gibson-type incision, a Penrose drain was left in all cases with its removal upon discharge of the patient.

• Study Type: Observational
• Enrollment (Actual): 6

Contacts and Locations

Study Locations

• Mexico
  • Estado De Yucatán
    • Mérida, Estado De Yucatán, Mexico, 97000
      • Mexican Social Security Institute: Regional General Hospital No. 1

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

6 Patients who underwent laparoscopic surgery.

Description

Inclusion Criteria:

• Patients with adrenal myelolipoma

Exclusion Criteria:

• Patients without CT scan with myelolipoma

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality	Mortality in surgery.	6 months

Collaborators and Investigators

• Sponsor: Instituto Mexicano del Seguro Social

Publications and helpful links

General Publications

• Samimagham H, Kazemi Jahromi M. Bilateral Adrenal Myelolipoma, A Case Presentation and Brief Literature Review. Iran J Kidney Dis. 2020 Jan;14(1):62-64.

Study record dates

Study Major Dates

• Study Start (Actual): February 28, 2024
• Primary Completion (Actual): October 20, 2024
• Study Completion (Actual): December 25, 2024

Study Registration Dates

• First Submitted: March 30, 2025
• First Submitted That Met QC Criteria: April 4, 2025
• First Posted (Actual): April 6, 2025

Study Record Updates

• Last Update Posted (Actual): April 6, 2025
• Last Update Submitted That Met QC Criteria: April 4, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: Adrenal, Incidentaloma, Myelolipoma, Laparoscopy.
• Additional Relevant MeSH Terms: Neoplasms; Neoplasms by Histologic Type; Neoplasms, Connective and Soft Tissue; Neoplasms, Adipose Tissue; Myelolipoma
• Other Study ID Numbers: 98235522

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anyone who ask via E-mail.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No