Resección Laparoscópica de mielolipoma suprarrenal gigante.

• Vargas Rocha, Vladimir Erik ^[1] ; Segales Rojas, Patricia ; Vargas Rocha, Brian E.
  1. [1] Caja Petrolera de Salud, Cochabamba, Bolivia
• Localización: Gaceta Médica boliviana, ISSN 1012-2966, ISSN-e 2227-3662, Vol. 44, Nº. 1 (Enero - Junio 2021), 2021, págs. 108-112
• Idioma: español
• Títulos paralelos:
  • Laparoscopic resection of giant adrenal myelolipoma
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• Resumen
  • español

    Son neoplasias suprarrenales benignas compuestas por tejido adiposo y hematopoyético. Corres`ponden a  6 - 16% de incidentalomas suprarrenales, su tamaño va desde milímetros hasta > 10 cm, y luego se denominan adrenomielolipomas gigantes.

    Síntomas de presentación comunes son dolor: abdominal: 22,5%, en hipocondrio: 13,9%, en flanco: 13,9%, masa abdominal: 5,2%, y raramente: disnea, dolor en espalda, fiebre, pérdida de peso y virilización.

    Masculino 61 años de edad, con tumor 15 x 12 cm, en glándula suprarrenal derecha, comprime polo superior de riñón derecho, de -20 UH, compatible con mielolipoma suprarrenal derecho gigante, hallazgo incidental durante estudio por crecimiento prostático, se realiza resección por abordaje laparoscópico, con excelentes resultados clínicos, sangrado mínimo y recuperación inmediata Es benigno y se diagnostica incidentalmente, no es funcional, pero se deben hacer estudios hormonales preoperatorios. El tratamiento depende de cada caso, se recomienda cirugia de tumores grandes >5 cm, sugerimos abordaje laparoscópico.

  • English

    Adrenal myelolipomas are benign adrenal neoplasms composed, as the name implies, of adipose tissue and myeloid (hematopoietic) tissue. They comprise between 6 and 16% of adrenal incidentalomas. The size of these tumors is variable and can vary from a few millimeters to more than 10 cm when they are called giant adrenomyelolipomas. The most common clinical presenting symptoms of adrenal myelolipomas are as follows: Abdominal pain: 22.5%, hypochondrial pain: 13.9%, flank pain: 13.9%, abdominal mass: 5.2%, and rarely, dyspnea, back pain, fever, weight loss and virilization. Presentation of the case: 61-year-old male, with the presence of a 15 x 12 cm tumor, dependent on the right adrenal gland, compressing the upper pole of the right kidney, -20 HU, compatible with giant right adrenal myelolipoma, incidental findings, during study protocol due to prostatic growth, a laparoscopic adrenal tumor resection procedure is performed, with excellent clinical results, minimal bleeding and immediate recovery. Conclusion: adrenal myelolipoma is a benign tumor that is diagnosed incidentally in most cases, it is known to be non-functional clinically, although preoperative hormonal studies should always be done. The treatment of adrenal myelolipomas depends on each clinical case, being a recommendation the surgical treatment of large tumors> 5 cm, we suggest that the laparoscopic approach be chosen, as it is the least invasive and with the lowest rate of complications, in addition of the prompt recovery of the patient.