Adrenalectomy Leading to Early Diagnosis of ALECT2 Amyloidosis

The diagnosis of amyloidosis requires high clinical suspicion and is often made only after significant clinical symptoms arise. Here, we present a case of amyloidosis diagnosed in a patient with an enlarging incidental adrenal cyst. Imaging and biochemical evaluation suggested that the cyst was benign and non-functional. Adrenalectomy was performed to treat symptoms of mass effect, and surgical pathology led to the diagnosis of leukocyte cell-derived chemotaxin 2 (ALECT2) associated adrenal amyloidosis. Patients with ALECT2 amyloidosis may have subclinical involvement of the adrenal glands, subcutaneous fat, and other tissues before developing the more common manifestation of renal amyloidosis. Early identification of patients with ALECT2 amyloidosis can assist in prevention of renal morbidity. Prevention of chronic kidney disease (CKD) should be among the main goals of managing patients with ALECT2 amyloidosis.