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Ji J, Zhong H, Ren X, He T, Xie G, Wang X. Bronchoscopic treatment of multiple bronchial myelolipomas: a case report and literature review. BMC Pulm Med 2023; 23:317. [PMID: 37653374 PMCID: PMC10472584 DOI: 10.1186/s12890-023-02608-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/20/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Extra-adrenal myelolipoma is an unusual entity, and endobronchial myelolipoma is rarer, which is often ignored by clinicians, delaying the disease and affecting the prognosis. CASE PRESENTATION A 71-year-old man with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus, with recurrent fever, cough, and expectoration for more than 2 weeks experienced relief in cough, phlegm reduction, and glycemic control with anti-inflammatory treatment. Further examination revealed that new growths obstructing all lobar bronchi impaired flexible bronchoscope entry. In order to relieve the patient's symptoms, under general anesthesia, we performed liquid nitrogen cryobiopsy at multiple bronchial openings, and then used argon plasma coagulation (APC) to achieve hemostasis. The pathological diagnosis was bronchial myelolipoma. The largest volume of the resected tissue was a mass measuring 0.6 cm × 0.4 cm × 0.3 cm at the bronchial opening of the upper lobe of the left lung. The patient's condition was stable and the symptoms were partially relieved after surgery. No recurrence was observed during the 12-month follow-up, although the long-term treatment efficacy is unknown. CONCLUSION Pathological biopsy is key to the diagnosis of endobronchial myelolipoma, and the development of the endobronchial myelolipomas may have been associated with long-term poor control of steroid levels in this patient.
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Affiliation(s)
- Jiali Ji
- Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Jiangsu, China
| | - Hongqin Zhong
- Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Jiangsu, China
| | - Xian Ren
- Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Jiangsu, China
| | - Ting He
- Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Jiangsu, China
| | - Guijuan Xie
- Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Jiangsu, China
| | - Xun Wang
- Department of Respiratory and Critical Care Medicine, Wuxi Second People's Hospital, Jiangsu, China.
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Alsayegh HA, Alhakeem RN, Almusallam WH, Alkhars AA, Alkhalaf J, Alsehaiw A, Alalwan QM. A case of bilateral posterior mediastinal myelolipoma. Radiol Case Rep 2022; 17:656-661. [PMID: 35003455 PMCID: PMC8715295 DOI: 10.1016/j.radcr.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
A 71-year-old female presented with chronic shortness of breath and underwent routine examination at the emergency department. A plain chest radiograph revealed a large lobulated posterior mediastinal mass that was incidentally found to be unrelated to the main complaint. Further cross-sectional images were obtained to characterize the lesion, which revealed bilateral involvement of a prevertebral mixed attenuation large mass with minimal enhancement postcontrast administration. Images were not conclusive in which the patient underwent ultrasound-guided biopsy and further histopathological examination, which revealed a myelolipoma of the posterior mediastinum, a rare entity to be seen at that location. Here, we present the case of posterior mediastinal myelolipoma.
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Affiliation(s)
- Hassan Ali Alsayegh
- Department of Radiology, King Fahad Hospital Hofuf, 36441 Prince Salman St, Eastern Province, Saudi Arabia
- Corresponding author
| | | | | | - Abdulwahab Abdulhaq Alkhars
- Department of Internal Medicine, King Fahad Hospital Hofuf, 36441 Prince Salman St, Eastern Province, Saudi Arabia
| | - Jawad Alkhalaf
- Department of Pathology, King Fahad Hospital Hofuf, 36441 Prince Salman St, Eastern Province, Saudi Arabia
| | - Ali Alsehaiw
- Department of Radiology, King Fahad Hospital Hofuf, 36441 Prince Salman St, Eastern Province, Saudi Arabia
| | - Qasem Mohammed Alalwan
- Department of Radiology, King Fahad Hospital Hofuf, 36441 Prince Salman St, Eastern Province, Saudi Arabia
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Ventura L, Martella EM, Rusca M, Ampollini L. Posterior mediastinal myelolipoma resected by video-assisted thoracic surgery. J Minim Access Surg 2019; 15:65-67. [PMID: 29737320 PMCID: PMC6293682 DOI: 10.4103/jmas.jmas_44_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Myelolipoma (ML) is a benign tumour composed of haematopoietic and mature adipose tissue commonly found in adrenal glands. Prognosis is usually good with an indolent clinical course. The occurrence of an ML in the extra-adrenal site is very rare. Herein, we report a very interesting and unusual case of ML located in the posterior mediastinum successfully resected by video-assisted thoracic surgery. The clinical and histological features are largely discussed.
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Affiliation(s)
- Luigi Ventura
- Department of Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Eugenia Marta Martella
- Department of Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Michele Rusca
- Department of Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Luca Ampollini
- Department of Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
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Bilateral Posterior Mediastinal Primary Myelolipoma. Ann Thorac Surg 2018; 106:e235-e237. [DOI: 10.1016/j.athoracsur.2018.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 04/01/2018] [Accepted: 04/02/2018] [Indexed: 11/23/2022]
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A rare case of gradual enlargement of a multifocal myelolipoma of the posterior mediastinum for 12 years after surgical resection of an adrenal myelolipoma. Int J Surg Case Rep 2018; 51:400-403. [PMID: 30273907 PMCID: PMC6170217 DOI: 10.1016/j.ijscr.2018.09.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION A myelolipoma is a rare benign tumor that is composed of adipose tissue and hematopoietic elements. Myelolipomas most commonly occur in the unilateral adrenal gland. Posterior mediastinal myelolipomas are extremely rare. We herein present a rare case of a multifocal myelolipoma of the mediastinum that gradually enlarged over a 12-year period after surgical resection of an adrenal myelolipoma. This is the first report of multifocal myelolipomas of the posterior mediastinum and adrenal gland. PRESENTATION OF CASE A posterior mediastinal tumor was incidentally found by chest X-ray and computed tomography (CT) examination of a 74-year-old woman. The patient had a medical history of resection of a myelolipoma of the left adrenal gland 12 years earlier. We performed tumor extirpation under video-assisted thoracic surgery (VATS). The size of the tumor was 4.5 cm, and the postoperative diagnosis was a myelolipoma. DISCUSSION Posterior mediastinal myelolipomas are extremely rare, and only 39 cases of mediastinal myelolipoma have been reported to date. No reports have described a multifocal myelipoma of mediastinal myelolipoma. To our knowledge, this is the first report of multifocal myelipomas of the adrenal gland and posterior mediastinum. CONCLUSION A differential diagnosis of myelolipoma of the posterior mediastinum is important in patients with a history of myelolipoma of the adrenal gland.
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Takano H, Takahashi K, Taki K. Myelodysplastic hematopoiesis mimicking the bone marrow in a mediastinal myelolipoma. Clin Case Rep 2017; 5:385-388. [PMID: 28396752 PMCID: PMC5378849 DOI: 10.1002/ccr3.777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 11/01/2016] [Accepted: 11/27/2016] [Indexed: 11/07/2022] Open
Abstract
Myelolipoma is one of the rare causes of posterior mediastinal tumor. Surgical excision is effective, which differs from the treatment of extramedullary disease usually concomitant with myelodysplastic syndrome. Cytogenetic analysis suggests the bone marrow cell originating myelolipoma.
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Affiliation(s)
- Hina Takano
- Department of Hematology Japan Red Cross Musashino Hospital Tokyo Japan
| | - Ken Takahashi
- Department of Thoracic Surgery Japan Red Cross Musashino Hospital Tokyo Japan
| | - Kazuhiro Taki
- Department of Pathology Japan Red Cross Musashino Hospital Tokyo Japan
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Shi Q, Pan S, Bao Y, Fan H, Diao Y. Primary mediastinal myelolipoma: a case report and literature review. J Thorac Dis 2017; 9:E219-E225. [PMID: 28449507 DOI: 10.21037/jtd.2017.02.65] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Myelolipoma is a kind of rare benign tumour composed of mature adipocytes and hemopoietic elements, and is most often found in the adrenal glands. Primary mediastinal myelolipoma (PMM) more rarely happens and has no definite symptoms, and mediastinal masses are usually found in chest examination. The patients normally receive a surgical resection and have a favorable prognosis after postoperative pathological diagnosis. Here, we present the case of PMM, which was resected via video-assisted thoracic surgery (VATS), and investigate recent correlative literatures to summarize its etiology, histopathology, differential diagnosis and therapeutic method. In this way, we aim to improve clinical doctors' understanding of this disease.
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Affiliation(s)
- Qingtong Shi
- Department of Cardiothoracic Surgery, The First People's Hospital of Yangzhou, Yangzhou 225000, China.,Department of Cardiothoracic Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225000, China
| | - Shu Pan
- Department of Cardiothoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yang Bao
- Department of Cardiothoracic Surgery, The First People's Hospital of Yangzhou, Yangzhou 225000, China.,Department of Cardiothoracic Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225000, China
| | - Huangxin Fan
- Department of Cardiothoracic Surgery, The First People's Hospital of Yangzhou, Yangzhou 225000, China.,Department of Cardiothoracic Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225000, China
| | - Yali Diao
- Department of Cardiothoracic Surgery, The First People's Hospital of Yangzhou, Yangzhou 225000, China.,Department of Cardiothoracic Surgery, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou 225000, China
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Shen C, Zhou K, Lai Y, Fan J, Liu L, Che G. Review of primary extra-adrenal myelolipoma of the thorax. J Surg Res 2016; 207:131-137. [PMID: 27979469 DOI: 10.1016/j.jss.2016.08.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/09/2016] [Accepted: 08/24/2016] [Indexed: 02/05/2023]
Abstract
Extra-adrenal myelolipoma happens in adrenal glands, and the thoracic location is extremely unusual. This is the first study involving 36 of patients with thoracic myelolipoma of English literature by investigating the clinical data, pathologic findings, radiological manifestation, and treatment strategy of all patients. Imageologic diagnosis including computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography scans is useful to identify the feature of extra-adrenal myelolipoma. Pathologic analysis is an effective method to clarify the diagnosis. In view of the potential progressive enlargement of the lesion, most myelolipomas are removed by surgery, and this operation has frequently been accomplished by using video-assisted thoracic surgery.
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Affiliation(s)
- Cheng Shen
- Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China
| | - Kun Zhou
- Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China
| | - Yutian Lai
- Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China
| | - Jun Fan
- Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China
| | - Lunxu Liu
- Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China
| | - Guowei Che
- Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu, China.
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Hosaka T, Hata Y, Makino T, Otsuka H, Koezuka S, Azumi T, Ejima K, Tochigi N, Shibuya K, Iyoda A. Mediastinal myelolipoma showing gradual enlargement over 9 years: a case report. J Cardiothorac Surg 2016; 11:91. [PMID: 27266711 PMCID: PMC4895879 DOI: 10.1186/s13019-016-0482-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 05/17/2016] [Indexed: 02/28/2023] Open
Abstract
Background Myelolipoma is a rare benign tumor composed of mature adipose tissue and normal hematopoietic tissue. Although surgical resection has been recommended due to the potential of progressive enlargement, the natural history of mediastinal myelolipoma has not yet been described. Herein we report a surgically resected mediastinal myelolipoma showing gradual enlargement over a period of 9 years. Case presentation A 70-year-old woman presented with a posterior mediastinal mass shadow detected by computed tomography (CT) examination. She had a medical history of sigmoidectomy for colon cancer 13 years previously. A CT scan showed a smooth, well-demarcated 2.8 × 2.1-cm paravertebral mass shadow, composed of a fat density area and a soft tissue density area, which showed gradual enlargement from a 1.6 × 1.0-cm nodule 9 years previously. This was not accompanied by chronic anemia or hematologic disease including thalassemia, and no abnormal accumulation was observed on bone marrow scintigraphy or fluoro-2-deoxyglucose positron emission tomography. With a clinical diagnosis of mediastinal myelolipoma, surgical resection was performed, and pathological examination confirmed the diagnosis. Conclusions We experienced a rare case with mediastinal myelolipoma showing gradual enlargement, with a tumor doubling time of 1,212 days.
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Affiliation(s)
- Tatsuaki Hosaka
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Yoshinobu Hata
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Takashi Makino
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Hajime Otsuka
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Satoshi Koezuka
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Takashi Azumi
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Kozue Ejima
- Department of Surgical Pathology, Toho University School of Medicine, Tokyo, Japan
| | - Naobumi Tochigi
- Department of Surgical Pathology, Toho University School of Medicine, Tokyo, Japan
| | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University School of Medicine, Tokyo, Japan
| | - Akira Iyoda
- Division of Chest Surgery, Toho University School of Medicine, Tokyo, Japan.
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Zeng Y, Ma Q, Lin L, Fu P, Shen Y, Luo QY, Zhao LH, Mou JH, Xiao HL. Giant Myelolipoma in the Spleen: A Rare Case Report and Literature Review. Int J Surg Pathol 2015; 24:177-80. [PMID: 26590175 DOI: 10.1177/1066896915617027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Myelolipomas are benign tumors, consisting of hematopoietic cells and mature adipose tissue, which mainly occur within the adrenal gland. Extra-adrenal myelolipomas are rare, and fewer than 60 cases have been reported in the literature. Here, we report a case of intrasplenic myelolipoma in a 42-year-old man with more than 1 month of abdominal pain. Computed tomography scanning revealed a giant, heterogeneous, well-demarcated mass in the spleen. Splenectomy was performed, and an intrasplenic giant mass was completely excised. The diagnosis of myelolipoma was made based on morphological examination. To the best of our knowledge, this is the third reported case of myelolipoma in the human spleen.
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Affiliation(s)
- Ying Zeng
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Qiang Ma
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Li Lin
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Ping Fu
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Yan Shen
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Qing-Ya Luo
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Lian-Hua Zhao
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Jiang-Hong Mou
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
| | - Hua-Liang Xiao
- Daping Hospital and Research Institute of Surgery, The Third Military Medical University, Chongqing, China
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