Findings:
Well-defined fat-containing pre-sacral mass with
mild enhancement
Differential Diagnosis:
1. Lipoma
2. Liposarcoma
3. Teratoma
Diagnosis: Myelolipoma
Discussion:
***
Clinical Manifestations
- benign
tumor that consists of mature adipose tissue and normal hematopoietic
components.
- up to
50% of all extraadrenal myelolipomas
- occur
predominantly in elderly women (average age, 65 years)
- usually
asymptomatic
*** CT
findings
-
well-circumscribed, predominantly fat-containing masses that contain areas of
soft-tissue attenuation
- The
attenuation value of fat in myelolipoma: higher than that of normal
retroperitoneal fat because of the mixed hematopoietic tissue.
*** MRI
findings:
- MRI
areas of high T1 signal intensity and intermediate to high T2 signal
intensity with loss of signal intensity on fat-suppressed images (the presence
of intratumoral fat)
-
variable enhancement.
-
possible intratumoral hemorrhage or calcification
***
Differential diagnosis:
-
Liposarcoma: infiltrative growth, unlike the well-encapsulated myelolipoma.
-
Teratoma: usually seen in younger individuals
- Presacral
myelolipoma occurs predominantly in elderly women is the single most
distinguishing feature that helps differentiate this tumor from other
fat-containing presacral lesions.
-
Technetium 99m (99mTc) sulfur colloid scintigraphy can be used to confirm the
presence of erythroid elements in myelolipomas
References:
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