Myelolipoma of the Pelvis: A Case Report and Review of Literature

Abstract

Myelolipomas are uncommon, benign tumors which typically occur in the adrenal glands and consist of mature adipose tissue and benign hematopoietic components. Myelolipomas can occur outside of the adrenal glands, but the presacral region, retroperitoneum, pelvis, and mediastinum are unusual locations for these tumors. It is important to recognize this entity in these locations since they can attain massive sizes leading to pressure symptoms and need to be differentiated from the malignant tumors like liposarcomas. We present a myelolipoma case in the presacral region. Our case illustrates the clinical approach of these tumors in such unusual locations.

Unusual discovery: Incidental diagnosis of adrenal myelolipoma, initially confused with liposarcoma, following bee sting bite, resolving chronic right hypochondrial discomfort - A case report

“…Adrenal glands are the most common site of occurrence of myelolipomas [ 6 ]. Adrenal myelolipomas are usually unilateral, variable in size and the average age for diagnosis of myelolipoma is midlife, and no gender differences were observed [ 10 , 11 ].…”

“…It is usually clinically silent [ 1 ] and considered as adrenal incidentaloma, which is defined as clinically unsuspected adrenal mass discovered on imaging studies conducted for reasons other than study of adrenal glands [ 5 ]. Symptoms tends to occur with rise in size of the lesion either due to mass effect or hemorrhage [ 6 ]. Symptoms varies from non-specific abdominal pain, constipation, vomiting, to haematuria and renovascular hypertension.…”

Clinical management of extra‑adrenal myelolipoma in the central nervous system: A case report

“…The tumor usually develops in the adrenal glands (4). Most of the lesions are isolated, while a few are multifocal (6,(8)(9)(10). The majority of EAMs occur in the anterior sacral region, peritoneal space and mediastinum (6,10).…”

Surgical management and outcome of Extra-adrenal myelolipomas at unusual locations: A report of 11 cases in a single center

“…The exact etiology of EAMs remains unclear, although several hypotheses have been put forward to explain the pathogenesis. The more accepted explanation is metaplasia in reticuloendothelial cells, caused by various stimuli including infection, stress, obesity, hypertension, diabetes and Cushing’s disease [14] . Several studies believe that embolization of the bone marrow tissue or the metaplastic alterations of embryonic primitive mesenchymal cells is also the possible cause of EAMs [3] , [15] , [16] .…”