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[Bilateral primary adrenal lymphoma]
Hanae Bakkali1, Hind el Omari-Alaoui, El Abbès Elghazi
1Service de Radiothérapie, Institut National d'Oncologie, Rabat, Maroc. h.bakkali@nancy.fnlcc.fr
Summary
Primary adrenal lymphoma is rare, often high-grade, and typically bilateral. This case highlights a 31-year-old with bilateral adrenal lymphoma presenting with acute adrenal insufficiency, treated successfully with chemotherapy and radiotherapy.
Area of Science:
- Oncology
- Endocrinology
Background:
- Primary adrenal lymphoma is an exceptionally rare malignancy, with fewer than 70 reported cases globally.
- Most adrenal lymphomas exhibit high-grade histology and a B-cell phenotype, frequently presenting with bilateral involvement.
Observation:
- A 31-year-old patient presented with acute adrenal insufficiency and bilateral adrenal masses on imaging.
- Diagnosis was confirmed as bilateral primary adrenal lymphoma via surgical biopsy and staging.
Findings:
- The patient received corticosteroid replacement, followed by 9 cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) chemotherapy.
- External beam radiotherapy was administered at 40 Gy, resulting in a partial response and 15-month survival at 3 months follow-up.
Implications:
- This case underscores the importance of considering lymphoma in the differential diagnosis of adrenal masses, especially in young patients with adrenal insufficiency.
- Combined modality treatment, including chemotherapy and radiotherapy, can achieve long-term survival in select cases of primary adrenal lymphoma.