Endocrinol Metab.  2011 Sep;26(3):243-247. 10.3803/EnM.2011.26.3.243.

A Case Report of Bilateral Adrenocortical Carcinoma Complicated by Adrenal Insufficiency

• Kim MJ
• Kim JH
• Kim TY
• Kim SW

• KMID: 2169176
• DOI: http://doi.org/10.3803/EnM.2011.26.3.243

Abstract

Adrenocortical carcinoma is often functional and presents with signs and symptoms of adrenal steroid hormone excess. Adrenal insufficiency secondary to bilateral adrenocortical carcinoma is a particularly rare complication. We recently encountered a case of bilateral adrenocortical carcinoma complicated by adrenal insufficiency. A 52-year-old male was transferred to this hospital complaining of general weakness and weight loss. A bilateral adrenal mass was detected on abdomen CT. Plasma cortisol and aldosterone failed to rise during the rapid ACTH stimulation test. The CT-guided adrenal biopsy revealed findings consistent with adrenocortical carcinoma. Left hemiparesis was developed and brain metastasis was detected via brain MRI. Despite the application of gamma knife surgery and chemotherapy, the disease progressed and the patient died.

Keyword

Adrenal cortex neoplasm; Adrenal insufficiency; Adrenocortical carcinoma

MeSH Terms

Abdomen
Adrenal Cortex Neoplasms
Adrenal Insufficiency
Adrenocortical Carcinoma
Adrenocorticotropic Hormone
Aldosterone
Biopsy
Brain
Humans
Hydrocortisone
Male
Middle Aged
Neoplasm Metastasis
Paresis
Plasma
Weight Loss
Adrenocorticotropic Hormone
Aldosterone
Hydrocortisone

Figure

• 

  Fig. 1. Computed tomography of abdomen showed 5.0 cm sized bilateral adrenal mass.

• 

  Fig. 2. A. Biopsy of the adrenal mass showed poorly differentiated carcinoma (H&E stain, × 400). B. Immunohistochemistry showed positive results for vimentin staining (× 400).

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  Fig. 3. Brain MRI (T2 weighted image) showed 1.7 cm sized mass with peripheral edema in right frontal lobe.

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