Adrenal lymphoma presenting as primary hypoadrenalism in the elderly

Area of Science:

• Endocrinology
• Oncology
• Geriatrics

Background:

• Primary adrenal lymphoma is an exceptionally rare condition, particularly in the elderly population.
• Adrenal insufficiency, or hypoadrenalism, can present with non-specific symptoms like hypotension and unresponsiveness.

Observation:

• An 85-year-old male presented with hypotension and unresponsiveness.
• CT imaging revealed enlarged adrenal glands and lymphadenopathy, initially investigated for malignancy.
• A tetracosactide (short Synacthen) test confirmed adrenal insufficiency.

Findings:

• The patient was diagnosed with primary adrenal lymphoma causing hypoadrenalism.
• This rare presentation underscores the diagnostic challenge of adrenal lymphoma.

Implications:

• Adrenal lymphoma should be a key differential diagnosis in elderly patients presenting with adrenal gland hyperplasia, lymphadenopathy, and adrenal insufficiency.
• Early consideration can lead to timely diagnosis and management of this rare condition.