Synchronous gastric cancer and primary lymphoma of right adrenal gland: a case report

Clin J Gastroenterol. 2021 Oct;14(5):1350-1357. doi: 10.1007/s12328-021-01482-8. Epub 2021 Jul 20.

Abstract

This report presents an extremely rare case of synchronous gastric cancer and primary adrenal diffuse large B-cell lymphoma (DLBCL). An 82-year-old man underwent computed tomography, which revealed a heterogeneous appearing and hypodense adrenal mass and a gastric mass with no enlarged lymph nodes in the neck, mediastinum, abdomen, and inguinal region. Upper gastrointestinal endoscopy revealed a protruding gastric tumor. The specimens obtained from endoscopic biopsy were histologically confirmed to be adenocarcinoma. The hormonal findings eliminated functional adrenal tumor. The patient underwent distal gastrectomy with regional lymph node resection for gastric cancer and incisional biopsy of the adrenal mass. Based on the pathological findings, diagnoses of mixed mucinous and tubular adenocarcinomas of the stomach and adrenal DLBCL were confirmed. Postoperation, the patient received rituximab combined with low-dose doxorubicin, cyclophosphamide, vincristine, and prednisone (R-miniCHOP). Six courses of R-miniCHOP were planned, but were completed in only one course at the patient's request. The patient died 2 months after surgery.

Keywords: Adrenal lymphoma; Diffuse large B-cell lymphoma; Gastric cancer; Malignant lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Glands
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Male
  • Prednisone / therapeutic use
  • Rituximab / therapeutic use
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / surgery
  • Vincristine / therapeutic use

Substances

  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone