Primary adrenocortical carcinoma: CT evaluation with clinical correlation

Area of Science:

• Radiology
• Oncology
• Endocrinology

Background:

• Adrenocortical carcinoma is a rare but aggressive malignancy.
• Typical CT findings often suggest larger, heterogeneous tumors.

Purpose of the Study:

• To characterize CT findings of primary adrenocortical carcinomas.
• To evaluate the relationship between tumor size, CT appearance, and clinical presentation.

Main Methods:

• Retrospective review of clinical histories and CT findings.
• Analysis of 38 patients with primary adrenocortical carcinomas.

Main Results:

• Tumors frequently showed central necrosis, irregular enhancement, calcification, or a thin capsule.
• Liver metastasis was more common with left-sided primary tumors.
• Smaller tumors (≤6 cm) were associated with endocrinopathy, contrary to expectations for larger lesions.

Conclusions:

• Adrenocortical carcinoma can present as a small (≤6 cm), smooth, homogeneous, functioning mass on CT.
• This challenges the established concept that these tumors are typically large and heterogeneous.
• CT imaging characteristics and clinical presentation require careful consideration for accurate diagnosis.