A case of posterior mediastinal myelolipoma and a literature review of its imaging manifestations

TL;DR

This paper presents a case of posterior mediastinal myelolipoma and summarizes its imaging features based on a literature review.

Contribution

The study systematically summarizes the imaging features of mediastinal myelolipoma, which has not been previously done.

Findings

Most lesions (90.9%) were located between the 8th and 12th thoracic vertebrae.

Right posterior mediastinum was the most common location in unilateral cases (68.4%).

Imaging features included fat density (84.8%), mild to moderate enhancement (93.9%), and encapsulation (75.8%).

Abstract

Mediastinal myelolipoma is a rare condition and has no obvious symptoms. In the past 20 years, some clinical cases have been documented. However, the literature has not systematically summarized its imaging features. The aim of this paper is to present a case of right posterior mediastinal myelolipoma and to review and summarize its imaging features. Twenty-six articles were included in our study, which included a total of 26 patients and 33 lesions; 90.9% of the lesions were located in the mediastinum at the level from the 8th thoracic vertebral body to the thoracic 12th vertebral body. Among the cases with unilateral mediastinum, 68.4% of the cases were located in the right posterior mediastinum. Bilateral lesions accounted for almost one-fourth of all lesions. After contrast medium was injected, 93.9% of the lesions had mild to moderate enhancement; 84.8% of the lesions contained fat density; and 75.8%, 69.7%, 87.9%, and 75.8% of the lesions showed clear boundary, regular shape, heterogeneity and were encapsulated, respectively. Only 12.1% of the lesions contained calcification. An inhomogeneous mass in the right posterior mediastinum near the spine, including fat density, is the predominant imaging marker of most mediastinal myelolipomas.

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