An Unusual Fat-Containing Presacral Tumor in an Elderly Patient (original) (raw)
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Presacral myelolipoma: a case report and review of imaging findings
Journal of radiology case reports, 2012
Extra-adrenal myelolipoma is a relatively rare entity, with fewer than 50 cases reported in literature. We present a case of a 79 year-old female who presented for evaluation of hip fracture following trauma, where a lobulated presacral mass with mixed fat/soft tissue attenuation was incidentally seen on initial bone algorithm pelvic CT. Subsequent MRI showed signal characteristics of a lesion with mixed fat and soft tissue composition. The lesion demonstrated stability on follow-up imaging. An elective surgical resection was performed which yielded a grossly fatty mass. The diagnosis of presacral myelolipoma was confirmed on microscopic examination. Following description of our case, we conduct a literature review of the imaging characteristics, diagnosis, and treatment of presacral myelolipoma.
Presacral myelolipoma. A case report and literature review
The neuroradiology journal, 2014
Many reports have described adrenal myelolipomas but there have been only a few reports of extra-adrenal myelolipomas. We describe a 74-year-old woman who came to our observation for MRI of the lumbar spine for typical lumbar back pain. In addition to signs of mild scoliosis and spondylo disc arthrosis, MR imaging revealed a presacral mass showing a heterogeneously high signal in all pulse sequences and almost completely suppressed on inversion recovery sequences for fat tissue. CT imaging confirmed the fatty nature of the lesion and no signs of bone involvement. These findings were most consistent with a diagnosis of a rare presacral myelolipoma as confirmed at histopathologic analysis. This work reports a case of one of the rarest presacral masses, emphasizing the role of imaging in the differential diagnosis of other presacral masses.
Myelolipoma of the Pelvis: A Case Report and Review of Literature
Frontiers in Oncology
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.
A rare case of co-existing adrenal and pelvic myelolipomas
Radiology Case Reports
We are reporting a case of co-existing left sided pelvic and right sided adrenal myelolipomas in a 68-year-old male patient. Both lesions were incidentally discovered on CT whilst undergoing a staging scan for suspected urinary bladder cancer. The patient had a background of hypertension and type 2 diabetes. Contrast enhanced CT scan showed both lesions to be of mixed fat and soft tissue density. Given the size, location, and attenuation characteristics of the pelvic mass, retroperitoneal liposarcoma was thought to be a differential diagnosis, prompting the decision for an elective CT-guided biopsy. Both masses were targeted successfully using core biopsy needles. Subsequently, histopathology results for both the right adrenal and the left pelvic masses showed features compatible with myelolipomas. The right retroperitoneal mass was compatible with an adrenal myelolipoma and left pelvic mass was deemed as an extraadrenal myelolipoma (EAML).
International Urology and Nephrology, 2005
Obstructive voiding symptoms may exceptionally be caused by extrinsic compression. We herein present a singular case of a 68-year-old male that presented with urinary retention and underwent prostate trans-urethral resection (TUR) with histology showing benign prostatic hyperplasia admixed with large amounts of myelolipoma tissue. To the best of our knowledge this is the first reported presacral myelolipoma diagnosed at prostate trans-urethral resection (TUR). Computed tomography revealed a 13 ยท 9 cm presacral mass displacing the rectum. Even though myelolipomas are regarded as benign, this case behaved aggressively since compressive effect evolved to severe constipation and eventually required a cystectomy.
Retroperitoneal lipoma, a rare cause of pelvic mass in women
Caspian Journal of Internal Medicine, 2021
Background: Lipoma is a benign mesenchymal tumor of soft tissue that occurs in almost all parts of the body where fat normally exists. Retroperitoneal lipomas are very infrequent condition with about 20 cases represented in the literature since 1980. They usually present as an abdominal mass or with pressure symptoms to adjacent organs. Case Presentation: A 66-year-old, post-menopausal woman referred to Imam Hossein Medical Center due to abdominal pain. Abdominopelvic magnetic resonance imaging (MRI) revealed a large mass containing fat component without enhancement on the right side of the pelvis. Tumor markers were within normal ranges. The patient underwent laparotomy and a 12 cm retroperitoneal mass which was located on the iliopsoas muscle with extension into the inguinal canal was resected with pathology report of lipoma. There has been no recurrence after one year of follow-up since surgery. Conclusion: In the differential diagnosis of retroperitoneal pelvic mass at all ages, lipoma should be considered as a rare cause.
Fat necrosis mimicking liposarcoma in a patient with pelvic lipomatosis
Clinical Imaging, 2003
Pelvic lipomatosis is a rare condition characterized by an overgrowth of normal fat in the perirectal and perivesical spaces. The most important differential diagnosis is liposarcoma. We present a case of pelvic lipomatosis associated with a mass, which was diagnosed radiologically as a liposarcoma, but surgical biopsy result revealed fat necrosis.
Pelvic mass in 46-year old man
Postgraduate Medical Journal, 1997
Excess adipose and heartburn 371 operative anaesthetic care, we can obtain a better definition of the tumour mass preoperatively and accept the challenge of demanding surgical procedures. Retroperitoneal lipomata are uncommon and have an indolent presentation. Lipomas occurring in this site are a different proposition than those in other sites and require meticulous pre-operative evaluation and an exacting surgical approach if recurrence and potential malignant transformation is to be avoided. 1 Pack GT, Tabah EJ. Primary retroperitoneal tumours, a study of 120 cases. Surg Gynaecol Obstet 1954; 99: 209-31. 2 Herdman JP. Primary retroperitoneal tumours. Br J Surg 1953; 40: 331-48. 3 Wells HG. Adipose tissue, a neglected subject. JAMA 1940; 114: 2177-84. 4 McLaughlin CW, Sharpe JC. Malignant fatty tumours of retroperitoneal regions. Am J Surg 1938; 41: 512 -6. 5 Serio G, Tenchini P, Nifosi A, Iacono C. Surgical strategy in primary retroperitoneal tumours. Br J Surg 1989; 76: 385 -9.