A case of adrenal myelolipoma with colonic cancer and gallstones

A 47-year-old female, referred to Kushiro Rohsai Hospital because of upper abdominal pain on January 10, 1986, was found to have a gallbladder stone on X-ray examination of her abdomen. On admission, the occult blood found in her stool was strongly positive and a barium enema and a colonoscopy showed an elevated lesion in the caecum. Subsequently, a diagnosis of a colonic cancer was made after a biopsy. Sonography and CT scans revealed a gallbladder stone and a right suprarenal mass 4 cm in diameter. At surgery, this gallbladder stone was found, as was a Borrman II type tumor in the caecum. The surface of an adrenal mass was hard and smooth and a cut of this surface showed a yellowish gray color. Microscopic examination revealed adrenal cortical tissue beneath the capsule with a mixture of hematopoietic and adipose tissue. These findings were compatible with myelolipoma. Postoperatively, a bone marrow aspiration was performed, but no definite abnormality was detected.