INCIDENTALLY DETECTED ADRENAL CORTICAL CARCINOMA

Purpose: Compared to benign adrenocortical tumors, adrenal cortical carcinomas (ACC) are rare occurrences affecting 1 out of 1,000,000 persons in the general population with a 3% prevalence rate in those older than 50 years old. Of interest is this unusual case of a nonfunctional adrenal cortical carcinoma in the left adrenal cortex in a 58-year old male. Methods: Laboratory evaluation was obtained while patient was in the hospital. This included plasma metanephrine, normetanephrine labs and a dexamethasone suppression test that ruled out pheochromocytoma and Cushing's syndrome. In addition, computerized tomography (CT) scan of the abdomen and pelvis was obtained. Results: The computerized tomography (CT) scan revealed a large, lobulated, heterogeneous density obliterating the left adrenal gland. Pathology reported adrenal cortical carcinoma from the biopsy. Conclusions: After surgical resection, further imaging was obtained that revealed metastasis into the lumbar spine. Oncology follow-up included mitotane chemotherapy.