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Case Reports in Medicine
Volume 2009 (2009), Article ID 916891, 4 pages
Case Report

Two Adults with Adrenal Myelolipoma and 21-Hydroxylase Deficiency

1Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway
2Institute of Medicine, Faculty Division Akershus University Hospital, University of Oslo, 1478 Lørenskog, Norway
3Department of Radiology, Akershus University Hospital, 1478 Lørenskog, Norway
4Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
5Institute of Medicine, University of Bergen, 5021 Bergen, Norway

Received 21 April 2009; Accepted 20 July 2009

Academic Editor: Paul Kaplowitz

Copyright © 2009 Ingrid Nermoen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We present incidentally discovered adrenal myelolipomas in two adult males with untreated congenital adrenal hyperplasia (CAH). The patients had simple virilizing form of CAH due to mutations in the CYP21 gene coding for 21-hydroxylase; one was heterozygous for the I172N mutation and the other compound heterozygous for the I172N and I2splice mutations. The masses were not removed since myelolipomas are considered benign tumors, and the tumor size did not increase during four- and nine-year observation periods. An adrenal myelolipoma is an important exception to the rule that large tumours should be removed. Untreated CAH with prolonged excessive ACTH stimulation might contribute to the growth of adrenal masses. CAH should be considered as a differential diagnosis of patients with adrenal masses or adrenal myelolipomas.