Table 1 compares clinicopathological features, treatments, and follow-ups of the intraosseous myelolipoma cases reported to date

Sakai T. et al 2021

25/F

Slow growing mass (for 10 years) on distal femur

The X-ray showed a 20 cm osteolytic lesion without bony demarcation and periosteal reaction with sunburst appearance.

CT scan showed a destructive lesion with invasive progression.

MRI showed high signal intensity on T1 and T2 and low signal intensity on the fat-suppression images.

Needle and open biopsies showed fatty and hematopoietic tissue with no atypia.

Hip disarticulation for complete tumor resection was considered but was not done due to the patient’s comorbidities and high risk for surgery.

No change in tumor size after two years.

C. Jaewon et al 2019

61/M

Slow growing mass with swelling on mandible

The panoramic radiograph showed multilocular and radiolucent lesions of maxilla and mandible.

CT scan showed trabeculation of lesions. Radionuclide bone scan showed the lesion is cold.

Mature adipose tissue and hematopoietic elements.

After the incisional bone biopsy was done for diagnosis, it was decided to conserve the lesion due to painlessness and wide range of lesions.

Not available

Wen J et al., 2015

18/M

Left chest mass

CT scan showed a well-circumscribed osseous mass with heterogeneous low density derived from the anterior 6th rib with a sclerotic rim

Histological examination revealed mature adipocytes mixed with hemopoietic cells consisting of trilineage elements: myeloid, erythroid and megakaryocytic cells, and local reticular fibers

Radical excision of the mass and part of costal pleura and 6^th rib

2 years follow-up revealed no complication or tumor recurrence

Papapietro N., 2009

80/M

Chronic right hip pain and a history of treated prostatic carcinoma

Radiographs revealed a well-defined intramedullary osteolytic lesion found in the intertrochanteric region, without cortical erosion; CT scan revealed an intraosseous hypodense lesion with fat attenuation. No cortical erosion or cortical deformity was observed. A post-contrast CT scan revealed no enhancement of the lesion.

CT-guided percutaneous needle biopsy and histology revealed a lesion composed of mature adipose tissue with areas of hematopoietic tissue. The adipocytes showed no cellular atypia or mitotic activity, and the hematopoietic tissue included erythroid and megakaryocytic elements as well as lymphocytes. No bony spicules or sinusoids were identified.

Intralesional curettage of the intertrochanteric region and filled with homologous bone and autologous platelet-rich gel.

Six months postoperative CT scan showed no evidence of recurrence of myelolipoma.

Sundaram M., 2007

35/F

Right hip pain

The radiographs demonstrated a 4 cm × 4 cm well-marginated mixed sclerotic and osteolytic lesion in the roof of the right acetabulum favoring the diagnosis of fibrous dysplasia.

The histology confirmed neither fibrous dysplasia nor lipoma but contained mildly hypercellular/ normocellular marrow with normal hematopoietic elements

Intra-lesional curettage

Symptoms decreased on follow-up

51/ not mentioned

Diabetic with hip pain CT scan confirmed a well-confined osteolytic lesion in the proximal femur.

CT scan confirmed a well-confined osteolytic lesion in the proximal femur.

Biopsy of the lesion showed hematopoietic bone marrow with occasional fat cells. Subsequently, the patient had a stress fracture of the lesion and resection specimen demonstrated hematopoietic marrow with mature red and white cell lines. There was no atypia, no granulomatous changes, and no fibrosis.

Data not available

Data not available

Chiarini L, 1992

Not mentioned/F

Right mandibular lesion which was grossly visible for 1 year.

Radiography showed presence of two dental elements within a total bone inclusion. There was a large translucent area between the lower mandibular canal and the two upper dental elements. This radiolucent area was not well-circumscribed and is homogenous with no septation. The homogeneity is consistent with a cystic structure. The second radiologic film reviewed (after biopsy result) confirms a similar contralateral translucent lesion with similar dimensions.

Histopathologic examination of the tissue showed adipose tissue and active myeloid tissue.

Excisional biopsy and extraction of the adjacent dental elements. A residual cavity was remained after the removal of mass and dental elements. Further physical examination and laboratory testing for possible extramedullary hematopoiesis was performed which was negative.

18 month follow up showed complete disappearance of the swelling. The follow up radiology documented a good healing of the tumor site.