AI Article Synopsis

  • Primary adrenal non-Hodgkin's lymphoma (NHL) is a rare and aggressive cancer, often with a poor prognosis, particularly for double-hit lymphomas that have specific genetic alterations.
  • A case involving a 73-year-old male exhibited a rare instance of double-hit primary adrenal lymphoma, which, despite the aggressive nature typically associated with it, showed a favorable outcome after surgery and chemotherapy.
  • Treatment involved laparoscopic removal of the tumor followed by R-CHOP chemotherapy, leading to 20 months of remission without recurrence, suggesting that this combination might be an effective first-line approach for similar cases.

Article Abstract

Introduction: Primary adrenal non-Hodgkin's lymphoma (NHL) is a rare neoplasm with poor prognosis. On the other side, double-hit lymphomas with BCL2 and MYC translocation are characterized by advanced disease stage, extranodal and central nervous system involvements at presentation or disease progression.

Case Report: We reported a 73-year-old male patient with double-hit primary adrenal lymphoma and preserved adrenal function, showing a favorable clinical course. Computed tomography of abdomen showed a 9 x 7 cm mass of the left adrenal gland. Laparatomy with left adrenalectomy was done and histological examination revealed diagnosis of a diffuse large B-cell NHL (DLBCL), non-GCB subtype. The patient was treated with 6 cycles of R-CHOP chemotherapy with reduced doses of doxorubicin because of the decreased left verticle ejection fraction. The patient was followed up regularly for 20 months with no evidence of tumor recurrence despite the inherently poor prognostic profile and double-hit phenotype of the disease.

Conclusion: R-CHOP chemotherapy in combination with adrenalectomy can be an effective first-line regimen for primary adrenal DLBCL, despite the inherently poor prognostic profile (non-GCB subtype, bulky disease, elevated lactate dehydrogenase and double-hit phenotype of the disease).

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http://dx.doi.org/10.2298/vsp1407689mDOI Listing

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