CTICasesThoracic Myelolipoma
Imaging findings
CT shows a well-circumscribed, non-aggressive paraspinal mass on the left containing pockets of fat and soft tissue, with minimal adjacent bone remodeling and no bone destruction. Core biopsy demonstrated myeloid and lipoid elements.
Key takeaways
Myelolipomas are benign tumors composed of mature adipose tissue and hematopoietic elements. While they classically occur in the adrenal glands, they can rarely present as extra-adrenal masses in the thorax (specifically the posterior mediastinum/paraspinal region), where they must be distinguished from extra-medullary hematopoiesis (EMH) and neurogenic tumors.
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