Hepatic myelolipoma
Updates to Article Attributes
Hepatic myelolipoma is a rare, benign fat containing-containing lesion of the liver, usually asymptomatic, and found incidentally. Its diagnosis by imaging remains difficult because of a lack of pathognomonic signs. The definite diagnosis is by resection or biopsy.
Epidemiology
ExtremelyHepatic myelolipomas are extremely rare. Only; only 17 cases have been described in the literature.
Clinical Presentationpresentation
UsuallyHepatic myelolipomas are usually asymptomatic and incidentally noted.
Pathology
TheThese lipomatous tumours of the liver are extremely uncommon. Their composition is a mixture of fatty, muscular, haemopoietic, and vascular tissues. According to and the predominant tissue type they includehistopathological spectrum includes angiomyolipomas, lipomas and myelolipomas.
The hepatic myelolipomas consist of adipose and myeloid tissue. Their pathogenesis, including hepatic localization remains unclear, it has been suggested and an association with liver cell metaplasia, other theories are related to endocrine factors has been suggested.
Radiographic Featuresfeatures
Ultrasound
Appears as a hyperechoic well-circumscribed, lobulated mass.
CT
Hypodense mass, with fatty attenuations betweenranging from -20 andto -100 UHHU. In some casesOccasionally, the attenuation value could beis greater than zero, and thiswhich is associate withdependent on the relative proportions of fat and other elements in the tumour.
-
NECTunenhanced: lobulated well-circumscribed hypodense mass with fatattenuationsdensity - arterial phase:
Nono enhancement - portal venous phase:
Remainshypodense without enhancement
MRI
Appears as a well-defined mass with a pseudocapsule, heterogenous fatty architecture and contents with elevated attenuation.
Treatment and Prognosisprognosis
Malignant transformation has not been described. SurgicalSurgical treatment is reserved for symptomatic patients or in case of diagnostic uncertainty.
Malignant transformation has not been described.
History and etymology
The first case of a hepatic myelolipoma was described in France by Grosdidier in 1973.
Differential Diagnosis
diagnosis
-<p><strong>Hepatic myelolipoma</strong> is a rare, benign <a href="/articles/fat-containing-liver-lesions">fat containing lesion of the liver</a>, usually asymptomatic, found incidentally. Its diagnosis by imaging remains difficult because of lack of pathognomonic signs. The definite diagnosis is by resection or biopsy. </p><h4>Epidemiology </h4><p>Extremely rare. Only 17 cases described in the literature. </p><h4>Clinical Presentation</h4><p>Usually asymptomatic and incidentally noted. </p><h4>Pathology</h4><p>The lipomatous tumours of the liver are uncommon. Their composition is of fatty, muscular, haemopoietic, and vascular tissues. According to the predominant tissue type they include <a href="/articles/hepatic-angiomyolipoma-1">angiomyolipomas</a>, <a href="/articles/hepatic-lipoma-2">lipomas</a> and myelolipomas. </p><p>The hepatic myelolipomas consist of adipose and myeloid tissue. Their pathogenesis including hepatic localization remains unclear, it has been suggested an association with liver cell metaplasia, other theories are related to endocrine factors. </p><h4>Radiographic Features</h4><h5>Ultrasound</h5><p>Appears as a hyperechoic well-circumscribed, lobulated mass. </p><h5>CT</h5><p>Hypodense mass, with fatty attenuations between -20 and -100 UH. In some cases, the attenuation value could be greater than zero, and this is associate with the proportions of fat and other elements in the tumour. </p><ul>-<li>NECT: lobulated well-circumscribed hypodense mass with fat attenuations</li>-<li>arterial phase: No enhancement</li>-<li>portal venous phase: Remains hypodense without enhancement</li>-</ul><h5>MRI</h5><p>Appears as a well-defined mass with a pseudocapsule, heterogenous fatty architecture and contents with elevated attenuation. </p><h4>Treatment and Prognosis</h4><p>Malignant transformation has not been described. Surgical treatment is reserved for symptomatic patients or in case of diagnostic uncertainty. </p><h4>History and etymology</h4><p>The first case of a hepatic myelolipoma was described in France by <strong>Grosdidier</strong> in 1973. </p><h5>Differential Diagnosis</h5><ul>-<li><a href="/articles/hepatic-angiomyolipoma-1">hepatic angiomyolipomas</a></li>-<li><a href="/articles/hepatic-adenoma">hepatic lipomas</a></li>-<li><a href="/articles/hepatic-adenoma">hepatic adenomas</a></li>-<li><a href="/articles/flash-filling-hepatic-venous-malformation">haemangiomas</a></li>- +<p><strong>Hepatic myelolipoma</strong> is a rare, benign <a href="/articles/fat-containing-liver-lesions-2">fat-containing lesion of the liver</a>, usually asymptomatic and found incidentally. Its diagnosis by imaging remains difficult because of a lack of <a href="/articles/pathognomonic">pathognomonic</a> signs. The definite diagnosis is by resection or biopsy. </p><h4>Epidemiology </h4><p>Hepatic myelolipomas are extremely rare; only 17 cases have been described in the literature.</p><h4>Clinical presentation</h4><p>Hepatic myelolipomas are usually asymptomatic. </p><h4>Pathology</h4><p>These lipomatous tumours of the liver are extremely uncommon. Their composition is a mixture of fatty, muscular, haemopoietic, and vascular tissues and the histopathological spectrum includes <a href="/articles/hepatic-angiomyolipoma-1">angiomyolipomas</a>, <a href="/articles/hepatic-lipoma-2">lipomas</a> and myelolipomas.</p><p>The hepatic myelolipomas consist of adipose and myeloid tissue. Their pathogenesis, including hepatic localization remains unclear, and an association with liver cell metaplasia has been suggested.</p><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Appears as a hyperechoic well-circumscribed, lobulated mass. </p><h5>CT</h5><p>Hypodense mass, with fatty attenuations ranging from -20 to -100 <a href="/articles/hounsfield-unit">HU</a>. Occasionally, the attenuation value is greater than zero, which is dependent on the relative proportions of fat and other elements in the tumour. </p><ul>
- +<li>unenhanced: lobulated well-circumscribed hypodense mass with fat density</li>
- +<li>arterial phase: no enhancement</li>
- +<li>portal venous phase: hypodense without enhancement</li>
- +</ul><h5>MRI</h5><p>Appears as a well-defined mass with a pseudocapsule, heterogenous fatty architecture and contents. </p><h4>Treatment and prognosis</h4><p>Surgical treatment is reserved for symptomatic patients or in case of diagnostic uncertainty. </p><p><a href="/articles/malignant-transformation">Malignant transformation</a> has not been described.</p><h4>History and etymology</h4><p>The first case of a hepatic myelolipoma was described in France by <strong>Grosdidier</strong> in 1973. </p><h4>Differential diagnosis</h4><ul>
- +<li><a href="/articles/hepatic-angiomyolipoma-1">hepatic angiomyolipoma</a></li>
- +<li><a href="/articles/hepatic-adenoma">hepatic lipoma</a></li>
- +<li><a href="/articles/hepatic-adenoma">hepatic adenoma</a></li>
- +<li><a href="/articles/flash-filling-hepatic-venous-malformation">haemangioma</a></li>
-<li><a href="/articles/focal-nodular-hyperplasia">hepatic focal nodular hyperplasia</a></li>- +<li><a href="/articles/focal-nodular-hyperplasia">focal nodular hyperplasia</a></li>
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