title: Autologous bone marrow transplanation for extramedullary plasmacytoma presenting as adrenal incidentaloma.
abstract: Extramedullary adrenal plasmacytoma (EMP) involving the adrenal glands is rarely encountered clinically. We report a A 47-year-old male who presented with bilateral adrenal incidentalomas. After confirming EMP, the patient received two consecutive autologous hematopoietic stem cell transplants (HSCT) using high-dose melphalan. Following HSCT, a serial follow-up helical CT revealed a substantial decrease in the size of both adrenal masses. Serial periodic serum protein and urine electrophoresis and immunofixation showed abrogation of a previously noted monoclonal band. At 50 months follow-up the patient was alive and well. Our patient is the first with EMP to have received an autologous HSCT, which may prove to have a role in therapy due to the immunological effect of the infused donor marrow T-lymphocytes against the clonal proliferation of abnormal plasma cells in extrammedullary sites.This case indicates that an EMP should be added to the differential diagnosis of adrenal incidentalomas.
authors.affiliation: Departments of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. ahmed@kfshrc.edu.sa
authors.forename: Mohammed
authors.initials: M
authors.lastname: Ahmed
authors.forename: Abdullah
authors.initials: A
authors.lastname: Al-Ghamdi
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Omari
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Aljurf
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Al-Kadhi
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000601:surgery*; D000313:Adrenal Medulla; D044963:Biopsy, Fine-Needle; D016026:Bone Marrow Transplantation / Q000379:methods*; D003937:Diagnosis, Differential; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010954:Plasmacytoma / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous