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Bilateral thoracic extraadrenal myelolipoma
T Franiel1, B Fleischer, B W Raab
1Department of Pathology, Georg August University, Robert-Koch-Str. 40, D-37075 Göttingen, Germany.
Summary
Bilateral thoracic myelolipoma, a rare condition involving adipose and hematopoietic tissue, was diagnosed in a 65-year-old female. This case highlights the importance of considering myelolipoma in the differential diagnosis of posterior mediastinal lesions.
Area of Science:
- Pathology
- Radiology
- Thoracic Surgery
Background:
- Myelolipomas are benign tumors typically found in the adrenal gland, composed of mature adipose tissue and hematopoietic stem cells.
- Extraadrenal myelolipomas are rare and can occur in various locations, including the mediastinum, accounting for approximately 3% of cases.
- The posterior mediastinum is a common site for various neoplastic and non-neoplastic lesions, requiring careful diagnostic consideration.
Observation:
- A 65-year-old female presented with non-specific symptoms.
- Chest roentgenograms revealed bilateral widening of the posterior mediastinum.
- Computed tomography identified bilateral, paravertebral lesions measuring 4.5 cm and 6.5 cm.
Findings:
- Surgical removal and subsequent pathomorphological examination confirmed bilateral thoracic myelolipoma.
- This diagnosis was made despite the rarity of myelolipoma in this location.
- The imaging findings mimicked other posterior mediastinal masses.
Implications:
- This case underscores the importance of including myelolipoma in the differential diagnosis for bilateral posterior mediastinal lesions.
- Accurate preoperative diagnosis can guide surgical planning and patient management.
- Further research into the imaging characteristics and optimal management of extraadrenal myelolipomas is warranted.