ECE2021 Eposter Presentations Adrenal and Cardiovascular Endocrinology (21 abstracts)
A 14 cm nonfunctioning left adrenocortical carcinoma in an adult man: a case report
Maatougui jasser 1 , Raboudi Mehdi 1 , Chayma Besrour 2 , Zouaoui Chadia 2 , Khiari Ramzi 1 , Ouertani Haroun 2 & Ghozzi Samir 1
1The Military Hospital of Tunis, Urology, Tunis, Tunisia; 2The Military Hospital of Tunis, Endocrinology, Tunis, Tunisia
Background
Adrenocortical carcinoma is a rare endocrine malignancy, with an unfavorable prognosis. Radical adrenalectomy is the gold standard for localized disease.
Case presentation
We report a case of a 47-year-old male with left abdominal pain and sensation of discomfort. Our patient didn’t present classical tumor symptoms, such as cachexia or night sweats. Computed tomography revealed a left heterogeneous retroperitoneal enhancing adrenal mass measuring 17 cm, with high density (30 Hounsfield units), smooth margins, and a wash-out <60%. Hormonal evaluation was negative, with normal ACTH and cortisol level. Suppression test was negative. Measurement of plasma renin activity and serum aldosterone levels showed no abnormalities. Plasmatic metanephrine and normetanephrine was also normal, excluding a pheochromocytoma. Open left adrenalectomy was performed by sub-costal approach. Pathology confirmed the diagnosis of adrenocortical carcinoma with positive microscopic surgical margins. Metastatic workup was negative. This case was discussed at a tumor board meeting. Adjuvant treatment by mitotane was not recommended. The patient has undergone a regular follow-up and has been disease-free for 6 months.
Conclusion
Adrenocortical carcinoma is a diagnosis challenge. Surgery remains the main treatment. A multidisciplinary management should be offered in those cases.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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