University of São Paulo, Bauru Medical School (FMBRU-USP), Alameda Doutor Octavio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
, Bauru, São Paulo, 17012-200, Brazil.
J Med Case Rep. 2024 Aug 12;18(1):377. doi: 10.1186/s13256-024-04682-1.
Myelolipoma is an uncommon benign tumor composed of mature adipose tissue and hematopoietic elements. These tumors generally affect the adrenal glands, with anomalous presentations being rare and with few cases described in the literature. Most myelolipomas are asymptomatic and discovered incidentally, either through imaging tests or at autopsies. However, depending on the location and size of the lesion, myelolipomas can cause symptoms of mass effect. This article aims to report a very rare presentation of a symptomatic primary myelolipoma affecting the ribs.
A 21-year-old white female patient presented with a complaint of burning chest pain over 3 months, with gradual worsening in intensity, accompanied by a progressively growing bulge in the right thoracic wall. The patient underwent thoracotomy of the fifth and sixth ribs with complete excision of the lesion with a safety margin. Thoracic wall reconstruction was performed using a polypropylene mesh. The patient had a good postoperative course and was discharged on postoperative day 3. Histopathological examination revealed a histological image consistent with myelolipoma.
This report underscores the importance of considering a myelolipoma diagnosis for tumor masses in the ribs.
骨髓脂肪瘤是一种由成熟脂肪组织和造血细胞组成的罕见良性肿瘤。这些肿瘤通常影响肾上腺,异常表现罕见,文献中描述的病例也很少。大多数骨髓脂肪瘤是无症状的,通过影像学检查或尸检偶然发现。然而,根据病变的位置和大小,骨髓脂肪瘤可能会引起肿块效应的症状。本文旨在报告一例非常罕见的肋骨原发性骨髓脂肪瘤的症状表现。
一名 21 岁的白人女性患者因胸痛 3 个月来就诊,疼痛逐渐加重,并伴有右胸壁逐渐增大的肿块。患者接受了第 5 和第 6 肋骨的开胸切除术,并用安全边界完全切除了病变。使用聚丙烯网进行了胸壁重建。患者术后恢复良好,术后第 3 天出院。组织病理学检查显示符合骨髓脂肪瘤的组织学图像。
本报告强调了在肋骨肿瘤肿块中考虑骨髓脂肪瘤诊断的重要性。