Adrenocortical carcinoma

Case contributed by Sherif Mohsen Shalaby
Diagnosis certain


Right sided colicky pain.

Patient Data

Age: 40 years
Gender: Male

A large heterogeneously enhancing right suprarenal bed soft tissue mass lesion seen inseparable from the right renal upper pole measuring about 12x7.5x10.5 cm (AP, TD, CC dimensions). This mass shows areas of tissue necrosis, with a few foci of calcification. The mass is seen stretching the IVC with no evidence of invasion. Patent right renal vein.

There is no adenopathy at the abdomen or pelvis. Normal liver, spleen, pancreas, left kidney, left suprarenal gland aorta and portal vein. No pulmonary nodules or other parenchymal abnormalities demonstrated. No pleural or pericardial collections. Unremarkable examined skeleton.  


Nuclear medicine

The mass is seen to be metabolically active (FDG) avid, eliciting maximum SUV~12.

There is no adenopathy or nodal hypermetabolism in the abdomen or pelvis.

Case Discussion

The differential diagnoses for such a mass are:

  • adrenal metastases
  • adrenal adenoma
  • pheochromocytoma
  • adrenal hemorrhage

The laboratory tests for pheochromocytoma were found to be normal (urine VMA). 

The histopathological result of this mass was found to be an adrenocortical carcinoma. 

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