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Adrenocortical Carcinoma: A Challenging Diagnosis
Marta Costa1, Sónia Santos1, Sofia Pereira1
1Internal Medicine, Unidade Local de Saúde Viseu Dão-Lafões, Viseu, PRT.
Cureus
|November 21, 2024
Summary
Adrenocortical carcinoma (ACC) can present insidiously, even with bone metastases. This rare cancer has a poor prognosis, highlighting the need for early diagnosis and multidisciplinary care.
Area of Science:
- Oncology
- Endocrinology
- Radiology
Background:
- Adrenocortical carcinoma (ACC) is a rare, aggressive endocrine malignancy with significant morbidity and mortality.
- ACC often presents with hormonal excess, non-specific symptoms, or incidentally, frequently at advanced stages with distant metastases.
Observation:
- A 62-year-old woman presented with back pain and osteolytic bone lesions, later developing hypercortisolism and hypokalemia.
- Imaging revealed a right adrenal mass, and a CT-guided biopsy confirmed adrenocortical carcinoma.
Findings:
- The patient's condition rapidly deteriorated, leading to death shortly after diagnosis.
- Metastatic disease, particularly to bone, is a strong indicator of poor prognosis in ACC.
Implications:
- This case underscores that adrenocortical carcinoma diagnosis can be challenging and may present with unusual initial symptoms like bone pain.
- Multidisciplinary management at specialized centers is crucial for patients with suspected or confirmed ACC, especially those with metastases.
