Bilateral Adrenal Lymphoma with Addison’s Disease: A Surgical Pitfall

Abstract

A 65 year old man presenting with abdominal and back pain was found to have bilateral adrenal masses. Phaeochromocytomas were initially suspected on the basis of increased catecholamine excretion. This diagnosis seemed unlikely in view of clinical findings and a negative ¹²³I-metaiodobenzylguanidine scintigraphy. A biopsy of the right adrenal mass revealed a diagnosis of primary adrenal B-cell lymphoma. Hyponatraemia and subtle clinical signs of adrenal insufficiency led to a diagnosis of Addison’s disease, a common complication of primary adrenal lymphoma. Thus, bilateral adrenal masses associated with Addison’s disease should raise the suspicion of possible primary adrenal lymphoma.

Key Words:

• Adrenal tumour
• lymphoma
• Addison disease

Additional information

Notes on contributors

J.E. Donckier

Pr. J. Donckier Department of Internal Medicine and Endocrinology University Hospital of Mont-Godinne B-5530 Yvoir, Belgium Tel.: [phone] Fax: [phone] E-mail: [email protected]