A Case of Posterior Mediastinal Myelolipoma

Ebana Hiroki, Okamoto Shoichi, Usui Ryo, Itou Atsushi, Shibuya Yasuhiro, Ishikawa Susumu

doi:10.2482/haigan.52.397

Background. Myelolipoma is a benign tumor that mainly occurs in the adrenal cortex. Here we report a rare case of posterior mediastinal myelolipoma. Case. A posterior mediastinal tumor was identified in 78-year-old man on a chest radiograph and CT scan during an examination involving another disease. He was referred to our department for further examination and treatment. A chest CT showed a tumor with a diameter of 40×26 mm on the right side beside the ninth thoracic vertebra. The tumor was a well circumscribed, low-density mass with poor contrast enhancement, but with no calcification. A chest MRI revealed a slightly high intensity heterogeneous mass on both T1 and T2 weighted images. Fat-suppressed T2 weighted image revealed that the tumor consisted of fat tissue. The tumor was resected using video-assisted thoracoscopic surgery. Postoperative pathological examination showed that the tumor was well covered with a capsule, and composed of mature adipose tissue and hematopoietic tissues including erythroblasts and myeloid cells. There was no history of blood disorder, and we diagnosed the tumor as an extraadrenal myelolipoma. Conclusion. Primary mediastinal myelolipoma is relatively rare, but should be considered in the differential diagnosis of posterior mediastinal tumors containing fat tissue. It is difficult to distinguish myelolipoma and extramedullary hematopoiesis using histopathological examination only, therefore we should also consider the presence of systemic disease, for example blood disorders. Because myelolipoma is a benign tumor, it is also possible to follow it conservatively if there are no coexisting symptoms.<br>

A Case of Posterior Mediastinal Myelolipoma

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