title: Adrenal incidentaloma caused by extramedullary haematopoiesis: conservative management is optimal.
abstract: We present a thalassaemic patient with extramedullary haematopoiesis in the adrenal gland, which is one of the rare sites of involvement. A 29-year-old man presented with a history of anaemia since childhood which required blood transfusion recently. On examination, he had pallor, icterus and splenomegaly with no other palpable abdominal mass. He was diagnosed to have β-thalassaemia. Ultrasonography of the abdomen showed an incidental right adrenal mass with splenomegaly; CT revealed a large right adrenal mass with heterogeneous density. Adrenal adenoma, carcinoma and extramedullary haematopoiesis were considered in the differential diagnosis. After excluding a functioning tumour, the diagnosis was confirmed by ultrasound-guided biopsy. Since the patient was asymptomatic, the adrenal lesion was managed conservatively.
authors.affiliation: Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Suganya
authors.identifier: http://orcid.org/0000-0001-7055-1789
authors.initials: S
authors.lastname: Sekar
authors.affiliation: Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Burad
authors.affiliation: Department of Haematology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Aby
authors.initials: A
authors.lastname: Abraham
authors.affiliation: Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Mazhuvanchary Jacob
authors.initials: MJ
authors.lastname: Paul
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging*; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000209:etiology; D000311:Adrenal Glands / Q000473:pathology*; D018246:Adrenocortical Adenoma / Q000175:diagnosis; D000328:Adult; D001706:Biopsy; D017707:Erythrocyte Transfusion; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D033162:Incidental Findings; D008297:Male; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D017086:beta-Thalassemia / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy