A Case of Multiple Myelolipomas Arisen in the Bilateral Posterior Mediastinum

Abstract

A 68-year-old man was referred to our hospital because of a 6 × 7 mm nodule in the upper lobe of the right lung and multiply accumulated nodules in the bilateral posterior mediastinum on CT scan performed before surgery for prostatic cancer. Metastatic lung cancer and mediastinal tumors including fatty components were suspected. We performed thoracoscopic partial resection of the lung and a biopsy of the mediastinal tumor ; the pulmonary nodule was resected by using a stapling device with a sufficient distance from the nodule. An intraoperative frozen section examination reported a suspicious nodule to be metastatic lung cancer from prostatic cancer. The mediastinal tumors were confirmed as dark red nodules ridging in the thoracic cavity from the outside of the parietal pleura. Incision of the pleura with an electric scalpel disclosed the lesion to be red, gelatinous and easily hemorrhagic tissue. We collected a portion of the tissue to send it to the Pathological Department. As a result of histopathological examination of the permanent preparation, the pulmonary nodule was diagnosed as primary lung cancer and the mediastinal tumors, as myelolipoma. We present this case with some bibliographical comments, because myelolipoma arising multiply in the bilateral posterior mediastinum is very rare.