Intraosseous myelolipoma.

Area of Science:

• Orthopedic Oncology
• Skeletal Radiology
• Bone Pathology

Background:

• Distinguishing benign bone lesions from other pathologies is crucial for accurate diagnosis and treatment.
• Imaging modalities like radiography and MRI play a key role in characterizing bone lesions.
• Histopathological examination is essential for definitive diagnosis of bone abnormalities.

Observation:

• Two patients presented with imaging-detected lesions in the acetabulum and femur.
• Radiographs and MRI revealed findings suggestive of fibro-osseous lesions or lipomas, but histology showed only normal or hypercellular marrow elements.
• One patient developed a stress fracture, necessitating surgical resection and prosthetic replacement.

Findings:

• Histopathological analysis in both cases revealed hematopoietic marrow without evidence of neoplastic or specific benign bone lesions.
• The imaging and microscopic findings were ultimately consistent with intraosseous myelolipoma, a rare bone tumor.
• The differential diagnosis included fibro-osseous lesions, lipomas, and hematopoietic hyperplasia, which were ruled out by integrated analysis.

Implications:

• Intraosseous myelolipoma should be considered in the differential diagnosis of bone lesions with mixed imaging features.
• This case series emphasizes the importance of correlating imaging findings with histopathology for diagnosing rare bone tumors.
• Accurate diagnosis of intraosseous myelolipoma can prevent unnecessary aggressive treatments for misdiagnosed conditions.