CTICasesEpithelioid Hemangioendothelioma arising in a Myelolipoma
Imaging findings
Non-contrast CT in a 67-year-old female shows a pre-vascular mediastinal mass located off-midline containing a mixture of fat, soft tissue, and dystrophic calcification, mimicking a teratoma. Pathological examination of the resected mass shows an epithelioid hemangioendothelioma arising within a myelolipoma.
Key takeaways
Myelolipomas are rare benign tumors composed of fat and myeloid elements. While most common in the adrenal gland, they can occur in extra-adrenal locations (such as the mediastinum or pelvis) and can rarely give rise to other neoplasms like epithelioid hemangioendothelioma. Pre-vascular fat-containing mediastinal masses are typically germ cell tumors (teratoma) or thymolipomas, but other rare entities should be considered when patient demographics or margins are atypical.
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