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BMC Surgery Jul 2014Myelolipoma is a rare neoplasm composed of yellowish adipose tissue and reddish-brown tissue corresponding to hematopoietic or hemorrhages. It typically occurs in... (Review)
Review
BACKGROUND
Myelolipoma is a rare neoplasm composed of yellowish adipose tissue and reddish-brown tissue corresponding to hematopoietic or hemorrhages. It typically occurs in adrenal glands as a solitary, well-circumscribed mass, and the thoracic location is extremely unusual.
CASE PRESENTATION
We present a rare case who is a 54 years old male with bilateral Myelolipoma of the posterior mediastinum. He underwent the surgery via video-assisted thoracic surgery both sides interval 3 months. Histological examination showed both tumors consisted of mature fat tissue and hematopoietic tissue, including myeloid, erythroid, and megakaryocytic elements surrounded. We discussed the etiology, histopathology, differential diagnosis and recommended management of extra-adrenal myelolipoma and analyzed the features of the thoracic myelolipoma including mediastinal and pulmonary location.
CONCLUSIONS
Literature review showed 16 similar cases, with a 2/1 male/female ratio and a mean age of 58 years. Eight of sixteen cases were observed in the mediastinum and six of sixteen cases were displayed in the pulmonary and one showed on the chest wall. CT and MRI scans are able to indicate the presence of extra-adrenal myelolipoma. Pathological analysis is an effective method to clarify the diagnosis. Observation and surgery are two regular treatment methods. Small, asymptomatic tumors should be monitored, while large tumors that cause unendurable symptoms may be removed by surgery.
Topics: Adrenal Gland Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Mediastinum; Middle Aged; Myelolipoma; Tomography, X-Ray Computed
PubMed: 25005140
DOI: 10.1186/1471-2482-14-42 -
Radiology Case Reports Mar 2022A 71-year-old female presented with chronic shortness of breath and underwent routine examination at the emergency department. A plain chest radiograph revealed a large...
A 71-year-old female presented with chronic shortness of breath and underwent routine examination at the emergency department. A plain chest radiograph revealed a large lobulated posterior mediastinal mass that was incidentally found to be unrelated to the main complaint. Further cross-sectional images were obtained to characterize the lesion, which revealed bilateral involvement of a prevertebral mixed attenuation large mass with minimal enhancement postcontrast administration. Images were not conclusive in which the patient underwent ultrasound-guided biopsy and further histopathological examination, which revealed a myelolipoma of the posterior mediastinum, a rare entity to be seen at that location. Here, we present the case of posterior mediastinal myelolipoma.
PubMed: 35003455
DOI: 10.1016/j.radcr.2021.12.001 -
Qatar Medical Journal 2013A fifty-two years old male presenting with a history of abdominal pain of six months duration was found on investigation to have a large non-functioning adrenal mass....
A fifty-two years old male presenting with a history of abdominal pain of six months duration was found on investigation to have a large non-functioning adrenal mass. Adrenal myelolipoma was diagnosed preoperatively and surgical resection was carried out. Only a small number of cases of giant adrenal myelolipoma (>3500 grams) have been reported. A brief review of literature is done.
PubMed: 25003051
DOI: 10.5339/qmj.2013.2 -
Clinical Endocrinology Jul 2020We aimed to describe clinical course of myelolipoma and to identify predictors of tumour growth and need for surgery.
OBJECTIVE
We aimed to describe clinical course of myelolipoma and to identify predictors of tumour growth and need for surgery.
DESIGN
A retrospective study.
PATIENTS
Consecutive patients with myelolipoma.
RESULTS
A total of 321 myelolipomas (median size, 2.3 cm) were diagnosed in 305 patients at median age of 63 years (range, 25-87). Median follow-up was 54 months. Most myelolipomas were incidentally detected (86%), whereas 9% were discovered during cancer staging and 5% during workup of mass effect symptoms. Thirty-seven (12%) patients underwent adrenalectomy. Compared to myelolipomas <6 cm, tumours ≥6 cm were more likely to be bilateral (21% vs 3%, P < .0001), cause mass effect symptoms (32% vs 0%, P < .0001), have haemorrhagic changes (14% vs 1%, P < .0001) and undergo adrenalectomy (52% vs 5%, P < .0001). Among patients with ≥6 months of imaging follow-up, median size change was 0 mm (-10, 115) and median growth rate was 0 mm/y (-6, 14). Compared to <1 cm growth, ≥1 cm growth correlated with larger initial size (3.6 vs 2.3 cm, P = .02), haemorrhagic changes (12% vs 2%, P = .007) and adrenalectomy (35% vs 8%, P < .0001).
CONCLUSIONS
Most myelolipomas are incidentally discovered on cross-sectional imaging. Myelolipomas ≥6 are more likely to cause mass effect symptoms, have haemorrhagic changes and undergo resection. Tumour growth ≥1 cm is associated with larger myelolipoma and haemorrhagic changes. Adrenalectomy should be considered in symptomatic patients with large tumours and when there is evidence of haemorrhage or tumour growth.
Topics: Adrenal Gland Neoplasms; Adrenalectomy; Adult; Aged; Aged, 80 and over; Follow-Up Studies; Humans; Middle Aged; Myelolipoma; Retrospective Studies
PubMed: 32275787
DOI: 10.1111/cen.14188 -
World Journal of Clinical Cases Oct 2020Primary hepatic myelolipoma is a rare hepatic mesenchymal tumor mixed by adipose tissue and bone marrow, and there is a lack of general guidelines related to its...
BACKGROUND
Primary hepatic myelolipoma is a rare hepatic mesenchymal tumor mixed by adipose tissue and bone marrow, and there is a lack of general guidelines related to its epidemiology and clinical management.
CASE SUMMARY
A 26-year-old woman was admitted to our department complaining of a newly found tumor on her left lobe of the liver. The tumor was painless and not associated with any systemic or localized compressive symptoms. Serological tests disclosed a slight increase of gamma-glutamyl transpeptidase (70.0 U/L) and total bilirubin (19.2 μmol/L). Ultrasonography showed a mass about 5.0 cm × 5.0 cm in size that was located in the left lobe of the liver and displayed hyperechoic and well-encapsulated characteristics. Surgical resection was applied, and the following histopathological examination observed a variable proportion of myeloid tissues scattering throughout mature fibrotic adipose tissues, in which myeloid, erythroid, and megakaryocytic cells can be found in magnified view. The follow-up did not show any changes 6 mo after surgery.
CONCLUSION
This case highlights an extremely rare hepatic mesenchymal tumor, the primary hepatic myelolipoma, and discloses the common characteristics behind this disease and gives clinical recommendations.
PubMed: 33083426
DOI: 10.12998/wjcc.v8.i19.4615 -
International Journal of Surgery Case... Mar 2024Myelolipoma, a benign tumor characterized by mature fat cells and hematopoietic cells, is predominantly found in the adrenal glands, accounting for 6-16 % of all...
INTRODUCTION
Myelolipoma, a benign tumor characterized by mature fat cells and hematopoietic cells, is predominantly found in the adrenal glands, accounting for 6-16 % of all adrenal tumors. These tumors are often asymptomatic and discovered incidentally during imaging. We present a rare case of concurrent adrenal and extra-adrenal myelolipomas, contributing to the limited research in this area.
CASE PRESENTATION
A 65-year-old female with a history of Steven-Johnson syndrome presented with epigastric pain, initially diagnosed with emphysematous cholecystitis. Imaging revealed unexpected lesions near the left kidney. During surgery for presumed cholecystitis, significant hemorrhaging occurred following an attempted biopsy of the left adrenal lesion. This complication necessitated a complete adrenalectomy. Pathological examination confirmed the presence of myelolipomas in the left adrenal gland, para-aortic, and left para-iliac regions.
DISCUSSION
The simultaneous occurrence of adrenal and extra-adrenal myelolipomas is exceptionally rare, posing diagnostic and management challenges. This case highlights the complexity of managing patients with multiple comorbidities and the critical importance of differentiating myelolipomas from other fat-containing retroperitoneal masses. The incidental discovery of these tumors and their potential for significant intraoperative complications, as seen in our case, underscores the need for careful surgical planning and thorough preoperative assessment.
CONCLUSION
This case emphasizes the diagnostic challenges and management complexities in patients with incidental findings of myelolipoma, particularly when accompanied by significant medical histories. The occurrence of unexpected intraoperative complications highlights the importance of cautious decision-making in surgical interventions. This report provides valuable insights into the unpredictable nature of medical practice and the management of rare pathologies.
PubMed: 38430892
DOI: 10.1016/j.ijscr.2024.109398 -
JFMS Open Reports 2022A 15 shorthair cat presented after having fallen down the stairs. Examination by the referring veterinarian had demonstrated tachycardia and a large abdominal mass. The...
CASE SUMMARY
A 15 shorthair cat presented after having fallen down the stairs. Examination by the referring veterinarian had demonstrated tachycardia and a large abdominal mass. The cat was referred for investigations. Blood tests demonstrated hyperthyroidism. A large, poorly vascularised abdominal mass was identified on ultrasonography. The mass was hyperechoic compared with the normal liver; however, the origin could not be determined. Fine-needle aspirate biopsies of the mass demonstrated extramedullary haematopoiesis. Surgical exploration revealed a 12 cm × 8 cm × 8 cm pale mass arising from the spleen. Histopathology determined this was a giant splenic myelolipoma.
RELEVANCE AND NOVEL INFORMATION
Splenic myelolipoma is rarely reported in the domestic cat, with only five cases documented within the literature, and none of these having described giant myelolipoma. Indeed, giant myelolipomas are rarely reported in the human literature and are most commonly adrenal in origin. The pathogenesis of these masses is unclear; there have been several incidences in people with endocrine disorders, and it has been hypothesised that their occurrence may be related to endocrine stimulation. Here we report the first case of giant myelolipoma in a hyperthyroid cat.
PubMed: 36249674
DOI: 10.1177/20551169221127889 -
Journal of Gastrointestinal and Liver... Mar 2010
Topics: Aged; Biopsy; Humans; Liver Neoplasms; Male; Myelolipoma; Predictive Value of Tests; Tomography, X-Ray Computed
PubMed: 20361087
DOI: No ID Found -
Urology Case Reports Sep 2023Myelolipoma is a benign tumor composed of mature adipose tissue and normal hematopoietic components. It usually occurs in the adrenal glands but rarely in the...
Myelolipoma is a benign tumor composed of mature adipose tissue and normal hematopoietic components. It usually occurs in the adrenal glands but rarely in the extra-adrenal region. However, it is difficult to differentiate extra-adrenal myelolipoma from well-differentiated liposarcoma on the basis of the radiological findings. We report the case of a 66-year-old male with perirenal and extra-adrenal myelolipoma who underwent radical tumor resection with nephrectomy after a preoperative diagnosis of liposarcoma. Intraoperative assessment by the surgeon and intraoperative pathological evaluation are important considering the divergent prognoses of myelolipoma and liposarcoma.
PubMed: 37664534
DOI: 10.1016/j.eucr.2023.102523 -
The Pan African Medical Journal 2019Adrenal myelolipoma (MLS) is a rare, benign and non-functional neoplasm, composed of adipose tissue and myeloid. We report a rare case of adrenal myelolipoma of a...
Adrenal myelolipoma (MLS) is a rare, benign and non-functional neoplasm, composed of adipose tissue and myeloid. We report a rare case of adrenal myelolipoma of a 20-year-old female revealed with chronic abdominal pain. Computed tomography (CT) scan of the abdomen guided diagnosis and surgical resection was performed given symptomatic and bulky mass. Histological examination confirmed the diagnosis. At 18 months after the surgery, the patient had no evidence of recurrence. The diagnosis of MLS is radiological. Therapeutic abstention is the rule for a small, asymptomatic tumor. The surgical removal is indicated when it is bulky (exceeds 7cm), symptomatic or hormonal activity.
Topics: Abdominal Pain; Adrenal Gland Neoplasms; Chronic Disease; Female; Humans; Myelolipoma; Tomography, X-Ray Computed; Young Adult
PubMed: 32153720
DOI: 10.11604/pamj.2019.34.180.20891