# Malicious Tumor? Pathological Fracture of the Femur in Children Caused by Myelolipoma: A Case Report and Review of Literatures

## TL;DR

A 15-year-old child experienced a bone fracture due to a rare tumor called myelolipoma in the femur, which was successfully treated and showed no recurrence after two years.

## Contribution

This is the first reported case of intraosseous myelolipoma in a minor presenting with a pathological fracture.

## Key findings

- The tumor was diagnosed using pathology and imaging techniques.
- Treatment involved a 'soft drill' technique and external fixation, with no recurrence observed after two years.
- The case highlights the rarity of myelolipoma in bone tissue and its presentation as a pathological fracture.

## Abstract

Myelolipoma is a kind of benign lipoma containing myeloid cells. It is a rare type of tumor that typically presents as an occasional adrenal tumor, generally manifesting as a nonfunctional adrenal mass. Although it can occur in extra-adrenal tissues, its occurrence in bone tissue is extremely rare. Most cases are discovered accidentally during physical examinations of adults, and there are currently no reports of cases with pathological fractures as the main symptoms. We present a case of a 15-year-old teenager who developed a pathological fracture caused by femoral myelolipoma. The diagnosis of the specific type of bone tumor of the patient was determined through pathology and imaging. To treat the condition, we utilized a technique known as the “soft drill” to fully access the tumor space, remove the bone septum, and scrape away the diseased tissue. The fracture was then stabilized using a hybrid external fixation. After a 2-year follow-up period, there was no recurrence of the bone tumor. This case is the first case of intraosseous myelolipoma that occurred in a minor with the initial symptom of pathological fracture, filling the gap in our existing body of knowledge and providing a reference for the treatment of this type of intraosseous myelolipoma.