In correspondence to “Solitary extramedullary plasmacytoma presenting as an adrenal tumor: case report and literature review”
We have published this interesting and rare case report in Gland Surgery in 2021 entitled “Solitary extramedullary plasmacytoma presenting as an adrenal tumor: case report and literature review” (1). As we had claimed that the case was extremely rare and the published article was the number 10th case of solitary extramedullary plasmacytoma (SEMP) in the adrenal gland; the same was claimed by some other authors too at that time (2,3). The reason of this confusion was because these cases published nearly at the same period of time. But interestingly we found few extra cases published close to our publication’s period (3,4), as well as we had missed a case published in 2016 by Cao et al. because of the same author’s name who had published two different cases of SEMP in nearly two years of time (5).
So, this correspondence is for the sake of completion of the data on SEMP in the adrenal gland. A case report published by of Cao et al. which was the first case of SEMP of the adrenal gland associated with human immunodeficiency virus (HIV). They underwent laparoscopic adrenalectomy and there was no recurrence at 2 years follow-up (5). Another case published by Gasz et al. in 2020 where an 81 years old male with multiple co morbidities was presented with left adrenal mass. The mass was diagnosed to be plasmablastic plasmacytoma after immunohistopathology, other laboratory, and radiological investigations. They performed laparoscopic partial resection (80% of the tumor) because they believe the patient was not fit for such an aggressive approach which in their opinion would be a nephrectomy, splenectomy, and adrenalectomy at least. The patient received radiotherapy and tolerated it well. At 14 months follow-up; they did not notice any progression of the residual tumor (4). Elbaset et al. also published a case report in 2020 in a 61 years old male which was diagnosed as right adrenal EMP associated with venous thrombus extended until the infra hepatic portion of inferior vena cava. They believe their case was the first case of adrenal EMP associated with venous thrombus. Chest CT with contrast showed multiple lymph node enlargement (but diagnosis of adrenal EMP was confirmed), and the case was associated with inferior vena cava (IVC) thrombus, therefore the multidisciplinary team decided to put the patient on chemotherapy (2). One more study by Chennoufi et al. in 2021 revealed a plasmacytoma in the left adrenal gland associated with HIV. The tumor was large enough and invaded the nearby tissues as well as the perilesional, inferior lobar parenchymal, and supraclavicular lymphadenopathy was detected on the left side. This was the second documented case of adrenal EMP associated with HIV according to them. The patient was referred to oncology for chemotherapy and radiotherapy but unfortunately she died 3 months later (3). We would like to update the table published in our last study to the present Table 1 which include all 14 cases of SEMP of adrenal gland until writing this article. As we have discussed in the previous paper, and after adding the new cases to the table of the current article; surgery is the treatment of choice used by most of these published articles when possible. So, we still believe radical surgery is not only a diagnostic method but a definitive treatment option which can be combined with other available treatment options if necessary.
Table 1
| No. | Authors’ name | Year of publication | Country | Gender | Age (years) | Tumor side | Tumor size (cm) | Treatment | Follow-up (months) | Recurrence | Ref. |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Kahara et al. | 2001 | Japan | Male | 52 | Right | 4*4*2 | LS+R+C | 12 | No | (6) |
| 2 | Asahi et al. | 2001 | Japan | Male | 52 | Right | 4 | LS+R+C | NA | NA | (7) |
| 3 | Fujikata et al. | 2002 | Japan | Male | 77 | Right | 10*8*4 | OS+R | 12 | No | (8) |
| 4 | Rogers et al. | 2004 | America | Female | 75 | Right | 3.5 | LS+R | NA | NA | (9) |
| 5 | Li et al. | 2007 | China | Female | 64 | Bilateral | R: 5*6*7; L: 3*4*4 | OS | NA | NA | (10) |
| 6 | Ahmed et al. | 2009 | Saudi Arabia | Male | 47 | Bilateral | R: 11*8; L: 13*8 | C+AHSCT | 47 | Regress R: 5.2*4*5.7; L: 4.5*5*3.5 | (11) |
| 7 | Blanco Antona et al. | 2011 | Spain | Female | 76 | Left | 6 | S+R | 40 | No | (12) |
| 8 | Cao et al. | 2014 | China | Male | 26 | Right | 2.8*3.1*4.5 | LS | 72 | No | (13) |
| 9 | Cao et al. | 2016 | China | Male | 35 | Right | 3.5 | LS | 24 | No | (5) |
| 10 | Townend et al. | 2017 | Australia | Male | 57 | Bilateral | R: 5.5; L: 9 | OS | NA | NA | (14) |
| 11 | Gasz et al. | 2020 | Austria | Male | 81 | Left | 9.7*7.5*10 | LS+R (partial resection) | 14 | No progression | (4) |
| 12 | Elbaset et al. | 2020 | Egypt | Male | 61 | Right | 11*9.5*12 | C | NA | NA | (2) |
| 13 | Khan et al. | 2021 | China | Female | 19 | Left | 8*6*5 | OS | 60 | No | (1) |
| 14 | Chennoufi et al. | 2021 | Morocco | Female | 50 | Left | 13.5*11* 12.9 | C+R | 3 | Died | (3) |
LS, laparoscopic surgery; OS, open surgery; R, radiotherapy; C, chemotherapy; AHSCT, autologous hematopoietic stem cell transplant; NA, not available.
Acknowledgments
Funding: None.
Footnote
Provenance and Peer Review: This article was a standard submission to the journal. The article has undergone external peer review.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-22-174/coif). The authors have no conflicts of interest to declare.
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