A case of adrenocortical carcinoma diagnosed 9 years after the discovery of adrenal incidentaloma

Endocrine journal

article

Daisuke Aono¹  Mitsuhiro Kometani¹  Takahiro Asano¹  Seigo Konishi¹  Shigehiro Karashima¹  Hiroko Ikeda³  Takahiro Nohara⁴  Takashi Yoneda¹ 

[1] Department of Health Promotion and Medicine of the Future, Graduate School of Medical Sciences, Kanazawa University;Medical Education Research Center, Graduate School of Medical Sciences, Kanazawa University;Division of Diagnostic Pathology, Kanazawa University Hospital;Integrative Cancer Therapy and Urology, Division of Cancer Medicine, Graduate School of Medical Sciences, Kanazawa University

关键词: Adrenocortical carcinoma;    Adrenal incidentaloma;    Computed tomography;   

DOI  :  10.1507/endocrj.EJ22-0171

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

4 cm in diameter, at initial presentation and grow rapidly. Therefore, there have been few reports of cases with long-term follow-up with imaging before ACC was diagnosed. Herein, we present a case of an adrenal mass that had remained small and unchanged for 5 years but later grew rapidly and was finally diagnosed as ACC. A 77-year-old hypertensive woman was referred to our hospital for the examination of a 5.4-cm left adrenal mass. Upon reviewing her previous unenhanced computed tomography (CT) scan, a 1.6-cm and 30 Hounsfield units (HU), homogeneous, round, left adrenal mass was incidentally detected 9 years ago. This mass remained unchanged until 4 years ago. One year ago, the mass enlarged to 3.0-cm and changed into an irregular form with heterogeneous density. The hormonal evaluation during the 9 years from the discovery of the AI was inadequate. The present examination diagnosed this case as ACC with subclinical Cushing’s syndrome. The patient underwent laparoscopic left adrenalectomy, and a histological diagnosis of high-grade ACC was made. The resected tumor had the CTNNB110 HU) are one of the findings that raise suspicion of malignancy. This case suggests that patients with findings atypical of adenomas on an initial unenhanced CT might be carefully followed up given the possibility of development of ACCs, even if the initial tumor size is small.

【 授权许可】

Unknown