Adrenocortical carcinoma

Case contributed by Dr Mais Ghassan Zmaily

Presentation

Presented to a GP clinic due to constipation and soiling.

Patient Data

Age: 8 years
Gender: Male
CT

There is a large heterogeneously enhancing soft tissue mass with large central area of necrosis and foci of calcification seen at right suprarenal space measuring about 8.5 x 9.5 cm in maximal axial dimensions.
The mass seen pushing the right kidney inferiorly with suspicious invasion of its upper pole.
It also exerts mass effect at the posterior aspect of the right hepatic lobe as well as the IVC with no definite invasion.
Patent right renal vessels with no evidence of thrombosis.

There are multiple enhancing soft tissue nodules seen at the posterior right perinephric space with mild surrounding fat stranding suggestive of the infiltration by the mass.
There are few prominent pericaval and right common iliac lymph nodes.

Case Discussion

An eight-year old male patient presented to a GP clinic due to constipation and soiling. During his workup an abdominal ultrasound was done and revealed a right-sided supra-renal mass, and therefore he was referred to us for further assessment.

His CT scan showed a large heterogeneously enhancing soft tissue mass with a large central area of necrosis and foci of calcification seen in the right suprarenal space, which appears to push the right kidney inferiorly with suspicious invasion of its upper pole. It also exerts mass effect at the posterior aspect of the right hepatic lobe as well as the IVC with no definite invasion. There are multiple enhancing soft tissue nodules seen at the posterior right perinephric space with mild surrounding fat stranding suggestive of the infiltration by the mass.

A few metastatic pulmonary nodules were also noted.

Wedge resection of 2 nodules confirmed the diagnosis of adrenocortical carcinoma.

His labs showed a normal hormonal profile.

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Case information

rID: 67980
Published: 9th May 2019
Last edited: 9th May 2019
Inclusion in quiz mode: Included
Institution: King Hussein Cancer Center

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