Adrenocortical carcinoma arising from the colonic mesentery

A 57-year-old woman presented with left-sided abdominal pain and was found to have a large retroperitoneal mass in the left upper quadrant. Surgical excision and histopathologic evaluation demonstrated an adrenocortical carcinoma arising from the colonic mesentery. Ectopic adrenocortical carcinomas are extremely rare tumors with an unknown incidence. Functioning tumors typically present with the Cushing syndrome and/or virilization, whereas nonfunctioning tumors result in abdominal pain from mass effect. They are highly aggressive tumors with an overall poor prognosis.