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Case Reports in Pathology
Volume 2012, Article ID 326418, 5 pages
http://dx.doi.org/10.1155/2012/326418
Case Report

Ectopic Functioning Adrenocortical Oncocytic Adenoma (Oncocytoma) with Myelolipoma Causing Virilization

1Department of Pathology and Laboratory Medicine, The Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
2Department of Radiology, The Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
3Department of Surgery, The Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA

Received 13 August 2012; Accepted 9 September 2012

Academic Editors: M. Marino, P. Tosi, D. Vlachodimitropoulos, and A. N. Walker

Copyright © 2012 Lea F. Surrey 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.

Abstract

Functioning adrenal adenomas are well-described entities that can rarely occur outside the adrenal gland in the ectopic adrenal tissue. Similarly, myelolipoma is an another benign lesion of the adrenal tissue which can rarely occur outside the adrenal gland. We report the first case of a testosterone producing an extra-adrenal adrenocortical oncocytoma accompanied by a myelolipoma. The patient presented with virilization and elevated androgen levels. Imaging revealed a retroperitoneal mass, which histologically consisted of oncocytes and intermingled myelolipoma. Postoperative androgen levels decreased to normal. The tumor cells were strongly positive for inhibin and Melan-A, supporting the adrenal origin. This case demonstrates a diagnostic challenge in which correlation with histology, immunohistochemistry, and serum endocrine studies led to the final diagnosis.