Presacral Myelolipoma: Diagnosis on Imaging With Pathologic and Clinical Correlation

Myelolipoma is a benign tumor composed of fatty and hematopoietic elements. Presacral myelolipoma is rare, with fewer than 40 cases reported in the English literature. It is important to make an accurate diagnosis because there are malignant diseases included in the differential diagnosis of a presacral fatty mass, particularly liposarcoma.

The combination of a well-encapsulated fat-containing presacral mass, lack of coinciding hematologic disease, and uptake on sulfur colloid scintigraphy support the diagnosis of a presacral myelolipoma.