Abstract
Myelolipoma is a benign tumor consisting of mature fat interspersed with hematopoietic elements resembling bone marrow. The vast majority occurs within the adrenal glands, but several cases of extra-adrenal myelolipomas (EAMLs) have been reported. We report a case of a 64-year-old male who presented with complaint of lower abdominal discomfort. CT scan of abdomen and pelvis showed a 6 cm × 5 cm, well-circumscribed, predominantly fatty mass in the presacral region. Histological examination of the pelvic mass revealed a myelolipoma heavily infiltrated by small lymphoid cell aggregates with immunophenotypic features of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL). Review of the literature revealed that there is only one published report of SLL/CLL involving a myelolipoma, which was also an extra-adrenal myelolipoma, and, therefore, our case is the second case of a SLL/CLL involving a myelolipoma that is an extra-adrenal myelolipoma. Extra-adrenal myelolipomas seem to the preferred myelolipomas for involvement by SLL/CLL.
Highlights
Myelolipomas are benign tumors, which most commonly occur in adrenal gland and are composed of a mixture of hematopoietic cells and adipose tissue
Surgical treatment becomes necessary when the tumor is functional or increases in size or becomes symptomatic. The purpose of this case report is to report a second case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) involving an extra-adrenal myelolipoma
Microscopic examination of hematoxylin and eosin stained sections demonstrated a mass composed of adipose tissue, bone marrow elements of all three cell lineages, and numerous small lymphocytic aggregates (Figure 2)
Summary
Myelolipomas are benign tumors, which most commonly occur in adrenal gland and are composed of a mixture of hematopoietic cells and adipose tissue. They are usually nonfunctioning asymptomatic adrenal tumors and often found incidentally on radiographic studies [1]. Extra-adrenal myelolipoma can cause tumoral mass effects on adjacent organs, or it is detected incidentally during routine workup. Surgical treatment becomes necessary when the tumor is functional or increases in size or becomes symptomatic. The purpose of this case report is to report a second case of SLL/CLL involving an extra-adrenal myelolipoma
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