Mantle cell lymphoma presenting as bilateral adrenal huge masses.

We present a middle-aged woman complaining ofweakness, lethargy and weight loss for 6 months. Positron emission tomography (PET )/CT scanrevealed huge bilateral adrenal masses with intense 18F-fluorodeoxyglucose avidity. Biopsy andimmunohistochemical staining were compatible with mantle cell lymphoma (MCL). The patientreceived six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP )followed by four cycles of intrathechal methotrexate chemotherapy. Bone marrow aspiration biopsy wasperformed for initial staging and also before bone marrow transplantation. Follow-up PET /CT scan aftercompletion of chemotherapy and before bone marrow transplantation demonstrated complete metabolicresponse with no evidence of abnormal metabolic activity in either adrenal gland or bone marrow. MCLhas an aggressive nature and is usually considered incurable; however, there have been a few reports indicating favourable treatment response when MCL is rarely arising from the adrenal glands. Dramatic response of a primary adrenal MCL to R-CHOP is documented in this case. [ABSTRACT FROM AUTHOR]