Primary myelolipoma presenting as a nasal cavity polyp: a case report and review of the literature

Smiley Annie George,Regi Thomas,Marie Therese Manipadam

doi:10.1186/1752-1947-6-127

Abstract

IntroductionMyelolipomas are rare, benign tumors comprising mature adipose tissue and hematopoietic elements. The vast majority occur within the adrenal glands, but extra-adrenal myelolipomas have also been reported in the presacral region, retroperitoneum, mesentery, stomach, spleen, liver, mediastinum and lungs. Here, we present a case of primary myelolipoma occurring in an unusual site: the nasal cavity. To the best of our knowledge, we believe that this location for extra-adrenal myelolipoma has not been previously described in the literature.Case presentationWe report a case of primary myelolipoma occurring in the nasal cavity of a 48-year-old Asian woman. We describe the etiology, pathology and differential diagnosis of extra-adrenal myelolipomas, and review the literature.ConclusionsWe chose to present this case because of its unusual location. Although myelolipomas are rare, we conclude that they it should be considered in the differential diagnosis of lesions in this site.

Highlights

Myelolipomas are rare, benign tumors comprising mature adipose tissue and hematopoietic elements
Case presentation: We report a case of primary myelolipoma occurring in the nasal cavity of a 48-year-old Asian woman
We chose to present this case because of its unusual location. We conclude that they it should be considered in the differential diagnosis of lesions in this site

Summary

Introduction

Myelolipoma is a rare benign tumor first described in 1905 by Gierke [1] and named by Oberling in 1929. Case presentation A 48-year-old Asian woman presented to an ear, nose and throat (ENT) surgeon at our facility with complaints of headache and bleeding from the right nasal cavity for 15 days. She was known to be hypertensive and was taking amlodipine and enalapril. Hemopoietic cells are made up of trilineage elements: myeloid, erythroid and megakaryocytic cells (Figures 2 and 3) Based on this histomorphology, a hematological investigation including bone marrow aspiration and trephine biopsy were performed to rule out any underlying hematological disorders. Bone marrow aspirate and trephine biopsy were normocellular without fibrosis Based on these findings, extra-adrenal myelolipoma was diagnosed. Our patient had an uneventful post-operative course and has remained disease-free at 36-month follow-up

Discussion

Conclusions

Gierke