ECE2013 Poster Presentations Adrenal Medulla (5 abstracts)
Adrenal ganglioneuroma in a patient with a non-Hodgkin lymphoma
Rosmeri Rivera Irigoín , Joana Nicolau Ramis , Alberto Gómez Gómez , Magdalena García Bonafé , Raquel Del Campo García , Carla Francés Artigas , Aleksandra Speranskaya , Ivana Zubillaga , Regina Fortuny Marqués & Lluìs Masmiquel Comas
Hospital Son Llàtzer, Palma de Mallorca (Balears), Spain.
Adrenal ganglioneuroma (AGN) is a rare neoplasm derived from the neural crest. It can be found along the paravertebral sympathetic plexus. Mean age at presentation is below 20 years. Most patients with AGN are asymptomatic and diagnosis is usually incidental.
Case report: Fourty three-year-old man with a personal history of hypertrophic cardiomyopathy in whom a follicular small cell non-Hodgkin lymphoma (NHL) was diagnosed after a biopsy of a left supraclavicular node. Initial extension study was conducted in December 2010 that included: a whole body CT, which showed multiple infiltrative lymphadenopathy and MRI of abdomen, where a 3.5×3 cm, well defined, spherical and homogeneously hypodense right adrenal mass was found. Also, PET scan confirmed multiple infiltrative lymphadenopathy, as well as infiltrative subcutaneous implants on both sides of the neck. Hormonal study was performed to exclude hyperfunction of the adrenal mass, which included: 24-h urinary free cortisol, 1-mg overnight dexamethasone suppression test, morning plasma cortisol, ACTH, renin, aldosterone, plasmatic catecholamines and its metabolites in plasma and urine, all of them within the normal range. After excluding hypefunction of the adrenal mass and not being able to exclude secondary infiltration of NHL, chemotherapy for treating NHL was started. After completing chemotherapy cycles no changes in size or morphology were seen in the adrenal mass, suggesting that it was independent of NHL. Consecutively, a laparoscopic right adrenalectomy was performed. Pathological study showed an AGN.
Conclusions: This is the first case of AGN described in a patient with a NHL. Adrenal masses are common findings in patients with hematological diseases that may be secondary to metastasic infiltration in up to 25% of cases. However, it should take into account all possible causes of adrenal masses, including the AGN.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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