An unusual diagnosis of paravertebral lesions: mediastinal myelolipoma.
BACKGROUND
Mediastinal myelolipoma is extremely rare. It is a benign nonfunctioning tumor composed of hematopoietic tissue and mature fatty tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, a definitive diagnosis is difficult to establish for rare extra-adrenal myelolipomas by imaging alone. Such tumors are often misdiagnosed as malignant retropleural liposarcoma, denoting a poor prognosis. Case presentation: We herein describe a 72-year-old man with multiple bilateral paravertebral mediastinal myelolipomas and discuss the imaging findings and differential diagnoses. We used a computed tomography-guided core biopsy to attain a preoperative diagnosis. Using this technique, we avoided an unnecessary surgical procedure for the patient's asymptomatic and relatively small lesions.


CONCLUSIONS
Instead of biopsy by lesion excision, we advocate conducting a precisely targeted, minimally invasive computed tomography-guided core biopsy to obtain a definitive preoperative diagnosis and thus avoid unnecessary surgery for mediastinal myelolipoma, a benign nonfunctioning tumor.
['Qin|De-An|DA|https://orcid.org/0000-0002-3025-2706', 'Ren|Xiao-Qiang|XQ|', 'Zheng|Shuai|S|', 'Bi|Hong|H|']
D000273:Adipose Tissue D000310:Adrenal Gland Neoplasms D000368:Aged D001706:Biopsy D001853:Bone Marrow D002681:China D003937:Diagnosis, Differential D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008479:Mediastinal Neoplasms D008482:Mediastinum D018209:Myelolipoma D014057:Tomography, X-Ray Computed
diagnosis myelolipoma imaging biopsy Mediastinum treatment