A rare case of myelolipoma compressing a second-transplanted kidney: A case report and review of the literature

Myelolipoma is a rare benign neoplasm composed of mature elements of fatty and hematopoietic tissues. In addition to its low incidence, myelolipoma in kidney transplant patients is much rarer, with only a few cases of this entity reported in the literature. A 37-year-old diabetic patient was admitted to the hospital due to severe left abdominal pain and elevated creatinine levels of 4.4 mg/dl. The patient has a history of two kidney transplantations. The patient was investigated with different modalities of imaging, which revealed a mass adjacent to the renal graft that was suspicious for malignancy. Histopathological assessment of the resected lesion showed findings consistent with myelolipoma. Although it's uncommon, myelolipoma should be considered in the differential diagnosis of any renal or extra-renal lesion in kidney transplant patients, including those with a history of graft rejection as in our patient. In light of the rarity of the lesions, we affirm the significance of the clinicians' reporting such cases that they encounter in order to better understand the disease's biological behavior. •Myelolipoma is a rare benign neoplasm composed of mature elements of fatty and hematopoietic tissues•In addition to its low incidence, myelolipoma in kidney transplant patients is much rarer, with only a few cases of this entity reported in the literature•Our case demonstrates the need to be cognizant of this entity in kidney grafts and use appropriate diagnostic methods to avoid unnecessary invasive procedures in the future, particularly in patients with major co-morbidities