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Digestive Diseases and Sciences

, Volume 64, Issue 12, pp 3431–3435 | Cite as

Giant Retroperitoneal Myelolipoma: An Unusual Diagnostic GI Challenge—Case Report and Review of the Literature

  • G. Vigutto
  • A. LauroEmail author
  • S. Vaccari
  • M. G. Pirini
  • M. Diegoli
  • V. D’Andrea
  • I. R. Marino
  • M. Cervellera
  • V. Tonini
DDS–SIRC COOPERATIVE CONFERENCES
  • 49 Downloads

Abstract

Introduction

Myelolipomas are rare, benign neoplasms usually arising from the retroperitoneum. They represent an unusual diagnostic challenge due to their vague GI symptoms. We present a case of an 81-year-old patient complaining of severe dyspepsia. An abdominal CT scan and a fine needle biopsy lead to a diagnosis of giant retroperitoneal myelolipoma. A complete surgical resection was performed; no evidence of recurrent tumor was noted after 10 months.

Areas Covered

Giant myelolipomas are very rare lesions. Clinical diagnosis of myelolipomas can be problematic due to their indefinite symptoms. CT scan and fine needle biopsy can be useful to reach a diagnosis, although they cannot be used to exclude malignancy in giant lesions. Surgery is the principal treatment if the tumor is symptomatic or > 7 cm. Follow-up is not mandatory due to the lack of any example of recurrence described in literature.

Expert Commentary

Despite the size of the neoplasms, since most of the complaints are vague, patients with this diagnosis should be considered among patients with unexplained gastrointestinal symptoms. Since malignancy cannot be excluded based on preoperative and intraoperative biopsy, an aggressive surgical approach is essential.

Keywords

Myelolipoma Retroperitoneum Surgery Dyspepsia 

Abbreviations

ACTH

Adrenocorticotropic hormone

CT

Computed tomography

MDM2

Mouse double minute 2 homolog

MRI

Magnetic resonance imaging

US

Ultrasound

CDK4

Cyclin-dependent kinase 4

FISH

Fluorescence in situ hybridization

Notes

Compliance with Ethical Standards

Conflict of interest

None of the authors have any conflicts of interest pertaining to this work.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • G. Vigutto
    • 1
  • A. Lauro
    • 1
    Email author
  • S. Vaccari
    • 1
  • M. G. Pirini
    • 2
  • M. Diegoli
    • 3
  • V. D’Andrea
    • 4
  • I. R. Marino
    • 5
  • M. Cervellera
    • 1
  • V. Tonini
    • 1
  1. 1.Surgery Emergency DepartmentSt. Orsola University HospitalBolognaItaly
  2. 2.Pathological Anatomy DepartmentSt. Orsola University HospitalBolognaItaly
  3. 3.Preventive and Diagnostic Medicine DepartmentSt. Orsola University HospitalBolognaItaly
  4. 4.Department of Surgical Sciences, Umberto I HospitalLa Sapienza UniversityRomeItaly
  5. 5.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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