Adrenal Myelolipomas Involved by Plasma Cell Myeloma

Area of Science:

• Oncology
• Pathology
• Endocrinology

Background:

• Adrenal myelolipomas are benign tumors composed of mature adipose tissue and hematopoietic elements.
• The co-occurrence of plasma cell neoplasms within adrenal myelolipomas is exceptionally rare.

Observation:

• A review of 23 adrenal myelolipomas identified two cases (9%) with concurrent plasma cell myeloma.
• The affected patients were elderly (71 and 81 years old) with large tumors (7 cm and 8.5 cm).
• Microscopic examination revealed significant dysplastic plasma cell infiltration and light chain restriction.

Findings:

• Plasma cell myeloma was present in 9% of the reviewed adrenal myelolipomas.
• Neither patient had a prior diagnosis of plasma cell neoplasm.
• Clinical outcomes varied, with one patient stable at 1 year and another deceased at 3 years post-diagnosis.

Implications:

• This finding represents the first reported instances of adrenal myelolipoma involvement by plasma cell myeloma.
• Early recognition and diagnosis are crucial due to the potential for aggressive disease.
• Further research is warranted to understand the pathogenesis and optimal management of this rare entity.