Myelolipomas are benign tumors or tumor-like lesions, which are very rare. The myelolipomas consist of mature adipose tissue as well as variable parts of hematopoietic tissue. In most cases, they occur in the adrenal area. The name of the disease coined the French pathologist Charles Oberling.

What is a myelolipoma?

Myelolipomas are a rare disease that causes benign tumors. These are usually localized in the kidney area. Myelolipomas occur in women and men with the same frequency, with a peak in the 50th to 70th year. In autopsy studies, myelolipomas are found in 0.08 to 0.4 percent of all cases.

Myelolipomas are tumors of yellowish to brownish color, ranging in size from a few millimeters to 30 centimeters. The tumors are not encapsulated. As a rule, they occur singly and unilaterally in the adrenals. In rarer cases, they may also occur bilaterally and sometimes outside the adrenals.

They can occur, for example, in the liver, in the retroperitoneum, in the muscle fascia or in the mediastinum. Microscopic analysis reveals that myelolipomas are mainly composed of mature adipose tissue and myeloid cells. Partial myelolipomas also include bony metaplasia or hemorrhages.

causes

The causes responsible for the development of myelolipoma have not been sufficiently researched and therefore largely unknown. However, there are several theories about potential causes of myelolipoma. For example, in the discussion, the transformation (medical term metaplasia) of so-called reticuloendothelial cells into blood capillaries may be a possible cause.

Such transformations can occur as a result of certain stimuli such as stress, infection or necrosis. Sometimes it is also believed that myelolipoma is a place where extramedullary blood formation occurs. This is a form of blood formation that takes place outside the bone marrow. More recent studies indicate that both the bone marrow-like component and the fat content of the myelolipoma are constructed in the same way.

This leads to the conclusion that myelolipomas may indeed be true neoplasms of body tissue (medical term neoplasia). In addition, the literature discusses a possible association of myelolipomas with congenital enlargement of the adrenal glands (medical term adrenal hyperplasia).

Symptoms, complaints & signs

In principle, different symptoms can occur with existing myelolipomas. However, most of the tumors are asymptomatic. This means that the myelolipomas cause no noticeable symptoms or discomfort and therefore can not be noticed by the affected persons.

In such cases, the myelolipomas are usually found only by accident, for example in the context of radiological examinations. If they remain unrecognized and show no symptoms, it may happen that myelolipomas are not found until the autopsy. Symptoms noticeable by the affected patients often only arise with larger tumors.

In such cases, people with myelolipoma suffer from abdominal and flank pain. Very rarely, there is a relationship to endocrine disorders such as Conn syndrome, Cushing's syndrome or inherited adrenal hyperplasia, with corresponding symptoms.

Diagnosis & disease course

If typical symptoms of a myelolipoma appear, a specialist should be consulted immediately to arrange the necessary measures. For the diagnosis of myelolipoma radiological investigations are possible, which represent the internal organs and possible tumors. In any case, medical examinations are important because the disease has to be differentiated from other, more serious illnesses with similar symptoms.

Mostly the prognosis of myelolipomas is relatively good. So far, no malignant degeneration of myelolipoma to malignant tumors has been observed. In rare cases, complications may occur in which bleeding occurs. These are usually caused by traumatic or spontaneously occurring tumor ruptures. Secured data on the mortality associated with myelolipoma are not possible due to the rarity of the tumors.

complications

Since most cases of a myelolipoma are a tumor disease, this complaint presents the usual complications and risks of cancer. In the worst case, the tumor can also spread to other regions and thus damage other healthy tissue. This also reduces the life expectancy of the patient in some cases.

Not infrequently a myelolipoma therefore remains unrecognized, so that early treatment is not possible. Most patients suffer from abdominal pain or flank pain as a result of the disease. These pains can spread to the back or other parts of the body and cause discomfort. The quality of life is significantly reduced by this disease.

As a rule, a myelolipoma must be treated and removed only if it causes discomfort or if the cancer may spread. Without complaints, in most cases no treatment is performed. It does not lead to further complications and it usually sets in a positive course of disease. Successful treatment will not reduce the patient's life expectancy due to myelolipoma.

When should you go to the doctor?

If signs of a tumor are noticed, medical advice should be sought in any case. Persons who notice unusual lumps, tumors or skin lesions speak at best immediately with the family doctor. Even with a deterioration in health, which is due to no other cause, medical assistance is needed. The doctor can diagnose a myelolipoma and then initiate treatment immediately. If this occurs early, serious complications can be averted in many cases.

Persons who have ever had a myelolipoma or other benign tumor should inform the responsible doctor if a complaint occurs. Even people with pre-existing conditions and other dispositions, which favor the development of a tumor, should go to the doctor with said complaints. A myelolipoma can be detected by the general practitioner. Further treatment is provided by internists and specialists for tumors and metastases. During the period of treatment, regular consultation with the doctor must be made, as even benign tumors can cause complications that must be treated immediately.

Treatment & Therapy

The therapeutic measures in the presence of a myelolipoma depend on the individual disease and the severity of the lesion. Myelolipomas, which are small in size and do not cause symptoms in the affected patients, may be unavailable for the time being.

In this case, the myelolipoma must be subjected only to a regular specialist examination in order to prevent possible changes or potential complications in time. Myelolipomas, which are associated with noticeable symptoms, are usually treated by surgical removal of the affected adrenal gland.

Outlook & Forecast

Myelolipomas usually provide a good prognosis. Degeneracy does not occur and tumor ruptures are rare. Occasionally, the kidney tumor causes discomfort such as abdominal and flank pain. Endocrine disorders such as Conn syndrome can also occur. These and other side effects worsen the quality of life, but are not life threatening.

Mostly a drug treatment is possible. The myelolipomas themselves are surgically removed. Small tumors do not require treatment. However, regular check-ups by the doctor are necessary so that any degeneration can be treated early. If the myelolipoma degenerates, the prognosis worsens. The survival rate depends on the stage of the disease. The symptom picture also influences the prognosis. Life expectancy depends on the course of the tumor disease.

Successful therapy does not reduce mortality. The patient can lead a symptom-free life and has only to change the diet to relieve the kidneys. Exact data is not available due to the rarity of the condition. The specialist in charge can make a prognosis on the basis of the symptom picture and consult comparable cases for the evaluation of the life expectancy.

prevention

Concrete measures for the prevention of myelolipoma do not yet exist according to the current state of medical science. There are only indications that special external stimuli may favor the development of a myelolipoma in humans. Such stimuli include, for example, mental and physical stress, various infections or necrosis, which is understood to mean the death of cells in the living organism.

If typical signs of myelolipoma occur, such as pain in the abdomen and flanks, a doctor should be consulted immediately to arrange for adequate therapeutic measures.

aftercare

In a myelolipoma, the measures of follow-up are in most cases severely limited. In this case, the person concerned is primarily dependent on a rapid and early diagnosis of the disease so that it does not lead to further complications or to a further deterioration of the symptoms. A self-healing of myelolipoma usually does not occur, so that sufferers should ideally consult a doctor at the first signs and symptoms of the disease.

Treatment with myelolipoma is not always necessary, although the condition of the tumor should be checked regularly by a doctor. In some cases, surgery is necessary which can completely remove the tumor or the affected organ. After such an operation, the patient should rest and protect his body.

Efforts or other stressful and physical activities are foreseeable. Likewise, regular checks by a doctor are important even after the procedure. Whether it comes through the myelolipoma to a reduced life expectancy of the person affected, can not be universally predicted. Furthermore, sufferers usually have no special follow-up care for this disease.

You can do that yourself

The measures taken by the affected person in the presence of a myelolipoma depend on the individual clinical picture and the severity of the lesion. Smaller growths often cause no complaints and do not necessarily require treatment. Larger tumors should, however, be medically clarified and treated.

The patient can support the therapy by protecting himself and keeping in close contact with the responsible doctor. If the tumor grows in size, the doctor must be informed. Even serious complications such as pain attacks or even a rupture of the tumor require a quick clarification. In addition to the prescribed medicines, a number of natural remedies are also available to alleviate the pain. For example, preparations with arnica and belladonna have proven useful, but also marigold ointment can relieve the typical symptoms. The use of alternative remedies should be previously agreed with the physician.

Larger myelolipomas must be surgically removed. The most important self-help measure is to protect the body after surgery. The surgical wound must be cared for according to the doctor's instructions, since there is an increased risk of infection. Accompanying this regular visits to the doctor are indicated in order to detect a possible recurrence early on.

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