A case study of a 73 old with indeterminate stable adrenal lesion progressing to metastatic adrenal carcinoma

Riasat Muhammad Haroon; Shahzad Akbar; Khurram Qayyum; Abdelmajid Musa; Ryan Alavi; Mohamed Bashir; Sufyan Benamer; Shiva Mongolu

doi:10.1530/endoabs.109.EP43

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Endocrine Abstracts (2025) 109 EP43 | DOI: 10.1530/endoabs.109.EP43

SFEBES2025 ePoster Presentations Late Breaking (6 abstracts)

A case study of a 73 old with indeterminate stable adrenal lesion progressing to metastatic adrenal carcinoma

Muhammad Haroon Riasat , Shahzad Akbar , Khurram Qayyum , Abdelmajid Musa , Ryan Alavi , Mohamed Bashir , Sufyan Benamer & Shiva Mongolu

Author affiliations

Hull Royal Infirmary, Hull, United Kingdom

74 years old female admitted to orthopaedic ward following hip pain. She was unable to weight bear and hence x ray and subsequently a CT scan was done too which showed large destructive lucent lesion in left femoral neck with pathological fracture. There was a suggestion of her having malignancy, so a CT TAP was arranged which showed that she has got large ovoid mass in the upper abdomen which most likely is malignancy and had multiple metastatic bony deposits. On reviewing her previous notes, she was under endocrinology. At that time there was no adrenal MDT in the hospital. A scan was done in 2017 which showed that she had large heterogenous lesion arising from the left adrenal gland. This was in keeping with adenoma. Two ODSTs were done and the results were 54 and 62 respectively. The scan was rediscussed and there was a small indeterminate lesion in the inferior aspect of the gland. In 2018 the scan remained unchanged. In 2021 another scan was, and the presumed adenoma remained unchanged. The hormone profile in 2023 showed 24 hr UFC to be 338 and low dose dexamethasone suppression test was arranged. On this occasion she had operation done to excise the tumour and total hip replacement. The histology showed metastatic adrenocortical carcinoma. Retrospectively a lesion had been present since 2017 but it was very slow growing. This case highlights the importance of close working with MDT colleagues, review suspicious lesions in the MDT and be aware of dual pathologies as in this case we can see that she had an adenoma in the super aspect of left adrenal gland and an indeterminant lesion in the inferior aspect.