Myelolipoma is an uncommon benign mesenchymal tumor consisting of mature adipocytes and hemopoietic elements that is mostly found in adrenal glands. Bilateral posterior mediastinal primary myelolipoma manifests extremely rarely, and only 11 such occurrences have been previously described. With no definite symptoms, pathologic evaluation is essential for diagnosis. This report presents a case of a 63-year-old man with a diagnosis of bilateral posterior mediastinal primary myelolipoma on the basis of radiologic findings who underwent surgical resection by video-assisted thoracic surgery. The aims of this report are to show the diagnosis of an unusual mediastinal lesion and improve understanding of this disease.
Congenital hyperinsulinism (CHI) is one of the common causes of recurrent or persistent hypoglycemia. It is marked by islet cell dysfunction leading to insufficient suppression of insulin secretion in the presence of serious hypoglycemia. CHI is genetic in origin, where children present with symptoms of hypoglycemia like irritability, listlessness, nausea, vomiting, tachypnoea, seizure or with long-term sequelae such as developmental delay and focal neurologic deficits, thus making it a medical emergency. Surgical management becomes essential in most of the cases with challenging perioperative management. We successfully managed three such cases with favorable postoperative outcome.
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