Myelolipoma mimicking osteosarcoma in the distal femur
| Autor: | Hiroaki Kimura, Hisaki Aiba, Takao Sakai, Hideki Murakami, Motoo Nakagawa, Hideo Hattori |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Myelolipoma
Extra-adrenal myelolipoma medicine.medical_specialty Malignant bone tumor Case Report Metaphysis Lesion 03 medical and health sciences 0302 clinical medicine Biopsy medicine Osteosarcoma medicine.diagnostic_test business.industry Incidentaloma EAM extra-adrenal myelolipoma medicine.disease Hydrocephalus CT computed tomography medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Radiology Differential diagnosis medicine.symptom business MRI magnetic resonance imaging |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction and importance Periosteal reactions indicate malignant bone tumors, including osteosarcoma; establishing an accurate diagnosis is key to determining the most appropriate treatment strategy. We describe a rare case of myelolipoma in the distal femur metaphysis with massive extraskeletal lesions and periosteal reactions. Case presentation A 25-year-old woman was referred to our hospital to treat a gradually expanding mass around her knee that grew to the size of a baby's head. She had a history of hydrocephalus caused by congenital cytomegalovirus infection and was bedridden for life. Radiography showed a prominent osteoblastic rim and osteolytic lesion with a moth-eaten appearance. Osteosarcoma was suspected due to excessive extraskeletal invasion and periosteal reactions. T1- and T2-weighted magnetic resonance images showed a high-signal-intensity homologous lesion. Biopsy specimens contained adipose and hematopoietic tissues. A myelolipoma was diagnosed. Due to her fragility, surgical intervention was suspended. Two years after diagnosis, the tumor size did not change. Clinical discussion Myelolipomas are benign tumors that typically arise from the adrenal gland and rarely develop in the extremities. This type of tumor typically does not cause any tumor-related symptoms or endocrine disturbances and has been reported as a type of incidentaloma. To effectively manage myelolipoma patients, differential diagnosis of tumors mimicking malignant bone tumors is important. Conclusion We successfully managed a destructive ectopic myelolipoma in the distal femoral metaphysis, with massive extraskeletal lesions and periosteal reactions. Clinicians should appropriately differentiate myelolipoma from tumors mimicking malignant bone tumors. Highlights • Report discusses a rare case of ectopic extra-adrenal myelolipoma in the femur. • The extraskeletal invasion and periosteal reactions resemble malignant bone tumors. • Clinicians should properly differentiate it from mimics of malignant bone tumors. |
| Databáze: | OpenAIRE |
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