Secondary bilateral adrenal Burkitt lymphoma with hepatic and renal involvement in a 17-year-old patient: A rare case report and literature review

Secondary adrenal involvement by lymphoma is rare in adolescents, and Burkitt lymphoma in this location is exceptional. We report a 17-year-old male with no prior medical history who presented with 3 months of persistent bilateral flank pain and significant unexplained weight loss. Contrast-enhanced computed tomography (CT) demonstrated large bilateral adrenal masses with central necrosis and direct contiguous extension into the adjacent liver and kidneys, while adrenal function remained preserved. No residual adrenal parenchyma was identifiable. CT-guided biopsy and immunohistochemistry confirmed Burkitt lymphoma with diffuse CD20 expression and a Ki-67 proliferation index approaching 100%. The patient received the pediatric-adapted Lymphomes Malins B (LMB) chemotherapy protocol. This case highlights the diagnostic challenges and aggressive behavior of adrenal Burkitt lymphoma in young patients and emphasizes the importance of early recognition, biopsy, and prompt initiation of intensive therapy.