Video-assisted thoracic surgery for primary myelolipoma of the posterior mediastinum

Abstract

Background: Myelolipoma is an uncommon tumor comprising adipose tissue and normal hematopoietic cells and mainly occurs in the adrenal cortex. Mediastinal myelolipoma is very rare; we report a case of posterior mediastinal myelolipoma that required surgical resection. Case Presentation: A 56-year-old male was diagnosed with a posterior mediastinal tumor by computed tomography. The tumor was originally noted in 2005, and during follow-up in March 2014, it was found to have increased in size. During consultation at our hospital, on magnetic resonance imaging (MRI), we considered the possibility that the tumor was malignant. Consequently, we resected the tumor by video-assisted thoracic surgery (VATS). The histopathological findings revealed that the tumor had undergone intrathoracic extramedullary hematopoiesis. However, after considering the patient's background and histopathological findings, we diagnosed the tumor as a thoracic extra-adrenal myelolipoma. Conclusions: Pathological analysis was instrumental in clarifying the diagnosis. We recommend surgery as a treatment option for posterior mediastinal tumors.

A rare case of gradual enlargement of a multifocal myelolipoma of the posterior mediastinum for 12 years after surgical resection of an adrenal myelolipoma

“…In the present case, the tumor gradually increased in size for 12 years. The retrospective observation period of 12 years in this case is longer than that of 9 years in previous reports [ 9 , 10 ]. In recent years, most of these tumors have been surgically resected by minimally invasive VATS.…”

Synchronous occurrence of a hepatic myelolipoma and two hepatocellular carcinomas

“…Extraadrenal myelolipomas are very rare[17]. They have been reported in the parietal pleura[18], presacral area[19], intrathoracic paravertebral area[20], mediastinum[21,22], gastric antrum[23], perirenal tissue[24], and right iliac fossa[25]. To date, only ten cases of hepatic myelolipomas have been reported in the English-language medical literature[3-12] (Table 1).…”

Primary mediastinal myelolipoma: a case report and literature review

“…It is composed of mature adipose and hemopoietic tissue, which is a benign tumor, and it is mainly found in the adrenal gland, while the mediastinal location is extremely unusual (3). Until now only 48 cases of mediastinal myelolipoma including our case have been reported (4)(5)(6)(7)(8)(9)(10). With the widespread application of the imaging examination method, its incidence has increased.…”

“…Myelolipoma has the characteristic of chromosomal aberration, which presents as 3q25 translocation to 21p41, and partial deletion of 21 or 17 chromosome short arms (13). Thus the occurrence of myeloid lipoma is associated with sharp reduction in cell apoptosis (8,9); the fifth point of suggests that it may be associated with obesity, chronic diseases and adjustments to the hormone change. Obesityrelated cases have been reported (14).…”

“…Minimally invasive thoracoscopic has been gradually and widely accepted. It is widely accepted that we can take VATS surgery to resect the tumor, the diameter of which is less than 80 mm (8). Triportal VATS was the most commonly used procedure.…”