Clinical Case of Metastatic Adrenocortical Carcinoma With Un
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A 37 year old man with no past medical history of hypertension or prior malignancy was admitted to the University Hospitals of Torrejon (Madrid, Spain) in July 2013 with worsening epigastric pain, decreased appetite, and 10 kg loss of weight over 6 months. His abdomen was mildly distended and on physical examination presented ascites. Computerized tomography revealed a huge heterogeneous adrenal tumor (13 cm in diameter) on the right side, compressing the inferior vena cava (IVC) and peritoneal carcinomatosis.

The laboratory studies did not show significant steroid hormone or catecholamine excess. A biopsy was then obtained from the adrenal mass. The tumor showed necrosis. The epithelioid component consisted of sheet and nests of loosely cohesive polygonal cells with clear and eosinophilic cytoplasm resembling adrenocortical cells. These cells showed highly atypical nuclei and large eosinophilic nucleoli. Immunohistochemical stains for AE1/AE3, S 100, calcitonin, ACTH, and chromogranin were negative. The Ki 67 proliferation index was 10%.....

http://wjon.org/index.php/wjon/article/view/936/700
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