Shen Cheng, Han Zhaojie, Che Guowei
Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu 610041, China.
BMC Surg. 2014 Jul 9;14:42. doi: 10.1186/1471-2482-14-42.
Myelolipoma is a rare neoplasm composed of yellowish adipose tissue and reddish-brown tissue corresponding to hematopoietic or hemorrhages. It typically occurs in adrenal glands as a solitary, well-circumscribed mass, and the thoracic location is extremely unusual.
We present a rare case who is a 54 years old male with bilateral Myelolipoma of the posterior mediastinum. He underwent the surgery via video-assisted thoracic surgery both sides interval 3 months. Histological examination showed both tumors consisted of mature fat tissue and hematopoietic tissue, including myeloid, erythroid, and megakaryocytic elements surrounded. We discussed the etiology, histopathology, differential diagnosis and recommended management of extra-adrenal myelolipoma and analyzed the features of the thoracic myelolipoma including mediastinal and pulmonary location.
Literature review showed 16 similar cases, with a 2/1 male/female ratio and a mean age of 58 years. Eight of sixteen cases were observed in the mediastinum and six of sixteen cases were displayed in the pulmonary and one showed on the chest wall. CT and MRI scans are able to indicate the presence of extra-adrenal myelolipoma. Pathological analysis is an effective method to clarify the diagnosis. Observation and surgery are two regular treatment methods. Small, asymptomatic tumors should be monitored, while large tumors that cause unendurable symptoms may be removed by surgery.
髓脂肪瘤是一种罕见的肿瘤，由淡黄色脂肪组织和对应造血组织或出血的红棕色组织组成。它通常作为孤立的、边界清晰的肿块出现在肾上腺，而发生在胸部的情况极为罕见。
我们报告一例罕见病例，患者为一名54岁男性，患有双侧后纵隔髓脂肪瘤。他通过电视辅助胸腔镜手术分两侧进行手术，间隔3个月。组织学检查显示两个肿瘤均由成熟脂肪组织和造血组织组成，包括被包围的髓样、红系和巨核细胞成分。我们讨论了肾上腺外髓脂肪瘤的病因、组织病理学、鉴别诊断和推荐的治疗方法，并分析了胸部髓脂肪瘤的特征，包括纵隔和肺部位置。
文献回顾显示有16例类似病例，男女比例为2/1，平均年龄为58岁。16例中有8例发生在纵隔，16例中有6例出现在肺部，1例出现在胸壁。CT和MRI扫描能够显示肾上腺外髓脂肪瘤的存在。病理分析是明确诊断的有效方法。观察和手术是两种常规治疗方法。小的、无症状的肿瘤应进行监测，而引起难以忍受症状的大肿瘤可通过手术切除。
