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Bilateral adrenal lymphoma with Addison's disease : a surgical pitfall
J E Donckier1, M Lacrosse, L Michel
1Department of Internal Medicine, University Hospital of Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium. julian.donckier@mint.ucl.ac.be
Acta Chirurgica Belgica
|May 23, 2007
Summary
Bilateral adrenal masses can indicate primary adrenal lymphoma, especially when accompanied by Addison's disease. This rare condition mimics other adrenal disorders, highlighting the need for thorough investigation.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Bilateral adrenal masses are uncommon and can present with diverse clinical symptoms.
- Initial diagnostic suspicion focused on phaeochromocytomas due to elevated catecholamines.
- Negative iodine-123 metaiodobenzylguanidine scintigraphy raised doubts about the initial diagnosis.
Observation:
- A 65-year-old male presented with abdominal and back pain, and bilateral adrenal masses.
- Clinical presentation and diagnostic tests were inconsistent with phaeochromocytoma.
- Biopsy revealed primary adrenal B-cell lymphoma.
Findings:
- Primary adrenal B-cell lymphoma was diagnosed in a patient with bilateral adrenal masses.
- Addison's disease, characterized by hyponatraemia and adrenal insufficiency, was identified as a complication.
- The findings suggest a link between primary adrenal lymphoma and Addison's disease.
Implications:
- Bilateral adrenal masses coupled with Addison's disease warrant consideration of primary adrenal lymphoma.
- This case underscores the importance of considering rare diagnoses in adrenal pathology.
- Early recognition of primary adrenal lymphoma can guide appropriate treatment and management strategies.
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