title: A bilateral neoplasm in chest: a case report and literature review.
abstract: BACKGROUND
  Myelolipoma is a rare neoplasm composed of yellowish adipose tissue and reddish-brown tissue corresponding to hematopoietic or hemorrhages. It typically occurs in adrenal glands as a solitary, well-circumscribed mass, and the thoracic location is extremely unusual.
  
  
  METHODS
  We present a rare case who is a 54 years old male with bilateral Myelolipoma of the posterior mediastinum. He underwent the surgery via video-assisted thoracic surgery both sides interval 3 months. Histological examination showed both tumors consisted of mature fat tissue and hematopoietic tissue, including myeloid, erythroid, and megakaryocytic elements surrounded. We discussed the etiology, histopathology, differential diagnosis and recommended management of extra-adrenal myelolipoma and analyzed the features of the thoracic myelolipoma including mediastinal and pulmonary location.
  
  
  CONCLUSIONS
  Literature review showed 16 similar cases, with a 2/1 male/female ratio and a mean age of 58 years. Eight of sixteen cases were observed in the mediastinum and six of sixteen cases were displayed in the pulmonary and one showed on the chest wall. CT and MRI scans are able to indicate the presence of extra-adrenal myelolipoma. Pathological analysis is an effective method to clarify the diagnosis. Observation and surgery are two regular treatment methods. Small, asymptomatic tumors should be monitored, while large tumors that cause unendurable symptoms may be removed by surgery.
authors.forename: Cheng
authors.initials: C
authors.lastname: Shen
authors.forename: Zhaojie
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of Thoracic Surgery, West-China Hospital, Sichuan University, Chengdu 610041, China. cheguowei_hx@aliyun.com.
authors.forename: Guowei
authors.initials: G
authors.lastname: Che
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D018209:Myelolipoma / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed