Adrenal myelolipoma with keratoconus: A novel clinical association
A 52-year-old gentleman, diagnosed with bilateral keratoconus 13 years back during evaluation for decreased vision in right eye [Figure and ], hypertensive for last 4 years on amlodipine 5 mg/day, diagnosed diabetic 2 months back on metformin 1 g/day, was detected to have right adrenal mass on ultrasonography abdomen done as a part of evaluation for pain and heaviness in the left lumbar region of 4 weeks duration. Examination was significant for obesity (BMI –32.6 kg/m2), with acanthosis, absence of stigmata of Cushing's syndrome, normal blood pressure, soft hepatomegaly without any other palpable abdominal mass. Computerized tomography abdomen revealed 7.4 × 7.0 × 6.6 cm hypo-dense variegated left adrenal mass [–71 to –51 Hounsfield Unit (HU)] with smooth borders suggestive of adrenal myelolipoma. The right adrenal was normally visualized []. Hemogram, renal function, 9 am cortisol, over-night dexamethasone suppressed serum cortisol, 24 h urine fractionated metanephrines, and electrolytes were normal []. He was referred to the surgeon for removal of the left adrenal mass.