Endocrine Abstracts

JOINT3522

Introduction: Early and accurate diagnosis of adrenocortical carcinoma (ACC) is essential for improving prognosis. Recent studies highlight the potential of plasma steroid profiling in diagnosing malignancy in adrenocortical tumors.

Objective: This study aimed to evaluate the diagnostic value of 11-deoxycortisol in identifying ACC.

Materials and Methods: Two patients with suspected ACC and one patient with suspected recurrent disease underwent clinical, biochemical and imaging evaluation in our tertiary care center. Serum steroids, including 11-deoxycortisol, were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS).

Results: Two patients with large incidental adrenal masses showed significantly elevated levels of 11-deoxycortisol (1167 ng/dL and 1242.3 ng/dL, respectively, compared to the upper reference limit of 33 ng/dl). These levels correlated with tumor size. Both patients presented with hyperandrogenism and cortisol secretion. In the first case, 11-deoxycortisol level normalized following complete tumor resection, but in the second case the level remained elevated as the tumor was not amenable to radical resection. The third patient showed elevated 11-deoxycortisol level during follow-up (689 ng/dL), allowing early detection of recurrence of a clinically silent tumor. Histopathological examination confirmed the presence of ACC in all cases.

Conclusion: Our findings suggest that 11-deoxycortisol may serve as a valuable biomarker for the early diagnosis of ACC and for monitoring potential recurrence after surgery, thereby improving patient outcomes.