Adrenocortical carcinoma

Case contributed by Dr Akshit Aiyappa M J

Presentation

Presents with paresthesias of the upper limbs for 15 days. Also presents with right upper quadrant pain. Known hypertensive with recurrent hypokalemia.

Patient Data

Age: 40 years
Gender: Female
CT

Large, well-defined isodense lesion noted in the right suprarenal region on the non contrast series. It displaces the right kidney inferiorly. Fat planes with right kidney are well maintained.

Post contrast study shows progressive arterial enhancement with a few central non enhancing areas (likely representing areas of necrosis). Branches from the right renal artery and right inferior phrenic artery can be seen feeding the tumor. The tumor invades the inferior vena cava on the post contrast images. The infrarenal segment of the inferior vena cava is not opacified in portal venous phase.

Case Discussion

Ultrasound guided biopsy of the right suprarenal lesion was performed:

"Microscopic features showed linear cores of tumor tissue arranged in cords, trabeculae and sheets composed of cells having pleomorphic hyperchromatic nuclei, inconspicuous nucleoli and eosinophilic to bubbly cytoplasm. Atypical mitotic figures also noted. Areas of necrosis evident."

Features suggestive of adrenocortical carcinoma.

Patient underwent right adrenalectomy with excision of tumor embolus in inferior vena cava.

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Case information

rID: 87281
Published: 1st Mar 2021
Last edited: 1st Mar 2021
System: Urogenital
Tag: adrenal
Inclusion in quiz mode: Included
Institution: A J INSTITUTE OF MEDICAL SCIENCES

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