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Adrenal tumours: how to establish malignancy
  1. Vanita Toogood1,
  2. Sam Milliken2,
  3. Adrienne Morey3,
  4. Katherine Samaras1,4
  1. 1Department of Endocrinology, St Vincent's hospital, Darlinghurst, New South Wales, Australia
  2. 2Department of Haematology, St Vincent's Hospital, Sydney, Australia
  3. 3Department of Anatomical pathology, St Vincent's Hospital, Darlinghusrt, Australia
  4. 4Department of Endocrinology, Garvan Institute, Darlinghurst, New South Wales, Australia
  1. Correspondence to Dr Vanita Toogood, vanitatoogood{at}


Adrenal masses are commonly found in the course of abdominal investigations and present diagnostic challenges. The foremost issue is whether the mass is the cause of the symptoms being investigated. Additional important clinical questions are: (1) is the adrenal mass benign or malignant and (2) whether the adrenal mass is functional or non-functional? We present a case of a 48-year-old man with severe abdominal pain. Imaging revealed a very large adrenal mass. Differential diagnostic procedures were performed and a diagnosis of primary adrenal lymphoma, an extremely rare cause of adrenal malignancy, was made. He proceeded to chemotherapy with cyclical cyclophosphamide, doxorubicin, etoposide and prednisolone, in addition to rituximab. This case illustrates the importance of establishing the nature of adrenal masses, to rapidly facilitate appropriate treatment.

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