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Adrenal carcinoma: a case report.
D R Abeynayake1, Sopan V2, K J C Perera2
1National Hospital of Sri Lanka, Colombo 10, Sri Lanka. dhanushi.abeynayake@gmail.com.
Journal of Medical Case Reports
|May 31, 2022
Summary
Adrenal carcinoma, a rare cancer, can present unusually with microscopic hematuria. Early detection through awareness of rare symptoms like hematuria is crucial for timely diagnosis and treatment.
Area of Science:
- Endocrinology
- Oncology
- Urology
Background:
- Adrenocortical carcinoma is a rare endocrine malignancy with a poor prognosis.
- Common presentations include hypercortisolism, virilization, and compressive symptoms.
- Microscopic hematuria is an uncommon initial presentation of adrenocortical carcinoma.
Observation:
- A 67-year-old female presented with microscopic hematuria during evaluation for an acute coronary event.
- Biochemical tests revealed hypercortisolism, hypokalemia, and elevated testosterone with suppressed ACTH.
- Imaging identified a 7 cm right suprarenal mass suggestive of a lipid-poor tumor.
Findings:
- The patient developed Cushing syndrome features, including hirsutism and proximal myopathy, before adrenalectomy.
- Histology confirmed a right adrenal tumor with capsular and vascular invasion.
- Post-surgery, both hypercortisolism and hematuria resolved.
Implications:
- This case highlights a rare initial presentation of adrenal carcinoma.
- Increased awareness of hematuria as a potential symptom can aid in early diagnosis.
- Prompt evaluation and management are essential for improving outcomes in adrenocortical carcinoma.
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