Periadrenal mature cystic teratoma mimicking adrenal myelolipoma: a case report and review of the literature

This is the authors' abstract. We don't add key points for this paper.

Mature teratomas arising in the adrenal region are rare and may mimic adrenal myelolipomas, particularly when adipose tissue is predominant. A 72-year-old woman with uncontrolled hypertension was found to have an 8.6-cm fat-containing mass in the right adrenal region, radiologically diagnosed as an adrenal myelolipoma. Laparoscopic adrenalectomy was performed. Histologically, the tumor predominantly consisted of mature adipose tissue with scattered epithelial-lined cystic structures, neural tissue, cartilage, thyroid tissue, bone marrow elements, and smooth muscle, confirming a mature cystic teratoma. Only a small amount of compressed adrenal tissue was identified at the tumor periphery without direct histologic continuity, supporting a periadrenal retroperitoneal origin. This case highlights that fat-dominant mature teratomas can closely mimic adrenal myelolipomas and should be considered in the differential diagnosis of heterogeneous fat-containing masses in the adrenal region.