# Case report: Incidental MALT lymphoma of the left adrenal gland mimicking a metastatic spread within durvalumab maintenance treatment in inoperable stage III non-small cell lung cancer

## TL;DR

A patient with lung cancer on durvalumab treatment had an unexpected MALT lymphoma in the adrenal gland, highlighting the need for careful differential diagnosis.

## Contribution

This case report highlights the importance of considering non-metastatic conditions like MALT lymphoma during cancer immunotherapy.

## Key findings

- A unilateral MALT lymphoma was incidentally discovered in the adrenal gland during durvalumab treatment.
- The case underscores the need for multidisciplinary evaluation to avoid misdiagnosis in cancer patients.
- Radiological and histopathological assessments were crucial in confirming the adrenal lesion's nature.

## Abstract

Durvalumab after chemotherapy in non-operable stage III non-small cell lung cancer (NSCLC) is the standard of care worldwide. We present a patient with the incidental discovery of a unilateral MALT lymphoma of the adrenal gland and adrenalitis during durvalumab maintenance treatment detected by 18F-FDG-PET/CT. We assessed the clinical and histopathological findings, radiological examinations and overall treatment. Our work emphasizes the significance of considering other differential diagnoses and the importance of multidisciplinary treatment of the findings, especially within clinical trials.