Autologous bone marrow transplanation for extramedullary plasmacytoma presenting as adrenal incidentaloma.
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.
Ahmed
Mohammed
M
Departments of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. ahmed@kfshrc.edu.sa
Al-Ghamdi
Abdullah
A
Al-Omari
Mohammed
M
Aljurf
Mahmoud
M
Al-Kadhi
Yusuf
Y
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