Autologous bone marrow transplanation for extramedullary plasmacytoma presenting as adrenal incidentaloma

Solitary extramedullary plasmacytoma presenting as an adrenal tumor: case report and literature review

Solitary extramedullary plasmacytoma, an extremely rare case which accounts for about 3% of all plasma cell neoplasms, often occurs in the head and neck region such as para nasal sinuses, nasal cavity and oral cavity, it also occurs in the lymph nodes, lungs, thyroid, intestine, liver, pancreas, testis, breast, or skin. Isolated primary plasmacytoma of adrenal is extremely rare and only nine documented cases have been reported in the literature. We are presenting the 10^th case which is the youngest patient until now with symptoms of fever and hepatosplenomegaly. A 19-year-old female was admitted with an irregular fever for 20 days. After a series of investigations were carried out there were no CRAB symptoms (hypercalcemia, renal failure, anemia and bone lesions), no free light chain and no more than 10% increase in plasma cell on bone marrow examination. Computed tomography (CT) scan revealed a tumor in the left adrenal region, and it was diagnosed to be a solitary extramedullary plasmacytoma on biopsy. She underwent the tumor resection one month after admission and recovered well after operation without fever and was discharged from hospital on the thirteenth post-operative day. She has been followed up for 5 years without any sign and symptom of tumor recurrence. Extramedullary plasmacytoma of adrenal gland in an extremely rare disease and usually diagnosed late in life but it can present in younger patients with variable symptoms. However, the surgical treatment yields excellent long-term results. So, complete surgical resection of the lesion is not only a good diagnostic measure, but also an intent-for-cure treatment for solitary adrenal extramedullary plasmacytoma.

A Giant Solitary Adrenal Plasmacytoma in a Patient with HIV: A Rare Case Report and Review of the Literature

Solitary extramedullary plasmacytoma (EMP) involving the adrenal gland is an extremely rare malignancy. We report a case of a solitary adrenal plasmacytoma in an HIV-positive 50-year-old woman on antiretroviral therapy who presented with a rapidly progressing lumbar left masse. A CT scan objectified a locally advanced left adrenal mass measuring 135mm long axis. A biopsy was taken, and the histopathology with the immunohistochemical study objectified an adrenal gland plasmacytoma. The skeletal survey and the sternal suction biopsy did not show any abnormalities. The diagnosis of a solitary EMP of the adrenal gland was made. There are only 10 cases of solitary adrenal plasmacytoma with only one case associated with an HIV-positive patient reported in the literature. Therefore, this paper is aimed at presenting the second case of an HIV-positive patient diagnosed with solitary adrenal plasmacytoma.

Bilateral extramedullary adrenal plasmacytoma: case report and review of the literature

Extramedullary plasmacytoma (EMP) accounts for only 3% of plasma cell malignancies; others include multiple myeloma, plasma cell leukemia and solitary plasmacytoma of bone. The majority of EMPs are found in the upper respiratory tract. Other sites include the GI tract, bladder, CNS, thyroid, breast, testes, parotid gland, lymph nodes and skin. There are eight cases in the literature of adrenal plasmacytoma, however, only two were bilateral. We describe our recent experience of bilateral adrenal plasmacytoma and review of the literature. While EMP may present as aggressive locally destructive lesions, excellent local control can be achieved in a majority of cases. Follow-up should be lifelong due to risk of progression to multiple myeloma.

Solitary extramedullary plasmacytoma of the adrenal gland: a rare case report with review of the literature

Plasmacytomas are monoclonal plasma cells proliferations originating either in localized osseous tissue or in soft tissue (extramedullary plasmacytoma, EMP). Although many such lesions are found in the bone marrow, fewer arise in extramedullary tissue. A solitary EMP involving the adrenal gland is extremely rare, with only 7 cases having been reported in the literature thus far. Here, we describe a rare case of solitary EMP in the right adrenal gland of a 26-year-old man that was managed by retroperitoneal laparoscopic resection, with no recurrence during 6-year follow-up.