[A case of adrenal cortical carcinoma]

We report a case of left adrenocortical carcinoma in a 23-year-old man. His chief complaints were spike fever attack and general malaise. Imaging examination revealed a heterogeneously enhanced mass at the site of the left adrenal gland. Non-functional adrenocortical carcinoma was suspected from hormonal studies. The mass was removed together with the left kidney because of severe adhesion to the renal pedicle. The histopathological findings showed adrenocortical carcinoma (pT3N0M0). Three months after surgery, local recurrence appeared and the tumor grew larger rapidly. Spike fever attack reappeared. No distant metastasis was detected. Two courses of systemic chemotherapy with o, p'-DDD, VP-16, adriamycin and cisplatinum were performed. Computed tomography after the chemotherapy showed progression. Although o, p'-DDD was administered continuously, the patient died of cancerous cachexia 8 months after the surgery. Autopsy could not be done.