SUMMARY
Presacral myelolipomas are exceedingly rare benign tumours composed of mature adipose tissue and haematopoietic elements. Here, we present a case report of an 81-year-old male with a complex medical history, who presented with recurrent disabling back pain and haematuria. Initial evaluation showed a presacral lipomatous mass, raising concerns of a liposarcoma. Multidisciplinary discussion raised the possibility of a presacral myelolipoma and suggested a nuclear scan for confirmation of this diagnosis. Given the absence of symptoms due to the presacral mass and patient comorbidities, a watchful waiting approach was adopted. This case underscores the diagnostic challenges associated with presacral masses, emphasising the necessity for accurate identification to guide optimal management strategies. Heightened awareness among clinicians and radiologists is crucial for timely and accurate management decisions in such cases. This report contributes to the existing literature by highlighting the diagnostic process and management of this rare entity.
(BELG J MED ONCOL 2024;18(6):239-243)
