Presacral Myelolipoma

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  • 仙骨前面骨髄脂肪腫の1例

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We report a very rare case of presacral myelolipoma discovered incidentally by preoperative examination of the sigmoid colon cancer, which we resected simultaneously with resection of another cancer. A 70-year-old man seen for melena was admitted to our hospital and given a diagnosis of sigmoid colon cancer. In the preoperative routine checkup, computed tomography revealed a round and heterogonous tumor located in the presacral space. Magnetic resonance imaging also revealed a round heterogonous tumor in the same place. Based on a preoperative diagnosis of presacral liposarcoma, we conducted sigmoidectomy and resection of the presacral tumor. The presacral mass, 4 cm in diameter, was encapsulated and solid, and was strongly attached to the surface of the sacrum, but there was no invasion. Microscopically, the adipose tissue and bone marrow elements, megakaryocytes, normoblasts, and myelocytic cells were noted. There were no malignant findings and myelolipoma was diagnosed. Myelolipoma is a benign tumor which is usually found in an adrenal gland and is rarely found in extraadrenal areas, including the presacral space. When we examined the fat-containing presacral mass, differentiation of liposarcoma and myelolipoma was quite difficult, so it can be said that surgical resection is efficient if lipoma cannot be diagnosed.

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