History: 84 yo female with palpable mass on pelvic examination
Solution: Presacral myelolipoma
The CT identifies a heterogeneous soft tissue mass in the presacral space. The mass is partially enhancing and has areas of low density as well, some of which seems to be fluid density and some of which appears even less dense.
Myelolipoma is a rare benign tumor composed of fat and hematopoietic elements. It most commonly affects the adrenal gland (85%), with the second most common location being the retroperitoneum (12%), and occasional case in the chest (3%). The appearance on CT is related to the fat attenuation mixed with marrow elements. In this case, the marrow elements are more prevalent. They are usually asymptomatic, but can occasionally result in retroperitoneal hemorrhage. Surgical resection is not necessary if the diagnosis can be made on percutaneous biopsy.
The CT identifies a heterogeneous soft tissue mass in the presacral space. The mass is partially enhancing and has areas of low density as well, some of which seems to be fluid density and some of which appears even less dense.
Myelolipoma is a rare benign tumor composed of fat and hematopoietic elements. It most commonly affects the adrenal gland (85%), with the second most common location being the retroperitoneum (12%), and occasional case in the chest (3%). The appearance on CT is related to the fat attenuation mixed with marrow elements. In this case, the marrow elements are more prevalent. They are usually asymptomatic, but can occasionally result in retroperitoneal hemorrhage. Surgical resection is not necessary if the diagnosis can be made on percutaneous biopsy.
CT Images
