[A case of giant malignant adrenocortical carcinoma]

Adrenocortical carcinoma is a rare disease. We report here a case of huge adrenocortical carcinoma. The aim of this study is to show the presence of this pathology in Madagascar despite its rarity, and the different steps undertaken for its diagnosis, treatment and evolution. A huge right adrenocortical carcinoma was incidentally diagnosed in a 42 year old man by ultrasonography and confirmed by computed tomography. The right adrenalectomy followed by an Op'DDD treatment gives good results in a short term. This case gave us the evidence of the usefulness of ultrasonography as a first intention investigation and the computed tomography as the only way to confirm the diagnosis. However, we can only rely on the histological findings even if the borderline between benignity and malignity is sometimes debatable. Open adrenalectomy is the main treatment, completed with an Op'DDD therapy whose efficiency is doubtful. The evolution is uncertain and the prognosis is poor.