Abstract
Background:
Adrenocortical carcinoma (ACC) is a rare malignancy with an incidence of 0.5-2 new cases per million people per year.
Method:
65-year-old female suffered from progressive pain in right knee in February 2022.
Results:
X-ray was done displaying 6cm cystic lesion in proximal tibia. Magnetic resonance (MRI) was performed after 2 months revealing right tibia malignant tumour, with highest probability –osteosarcoma. Afterwards general practitioner (GP) suggested chest and abdominal CT. Left side 10cm adrenal and 2cm kidney tumours and 2cm mass in between caecum and right psoas muscle were discovered. In July 2022 biopsy from right tibia tumour was done. Pathohistological examination revealed metastasis (MTS) of pheochromocytoma. In August 2022 patient was referred to university hospital for endocrine surgeon consultation and admitted urgently to department of endocrinology due to severe hypokalaemia and hypercortisolaemia. Treatment with fluconazole and spironolactone was started. Tumour markers CA 19-9, CEA, CA 15-3, CA 125 were negative. Control CT revealed 13cm left adrenal tumour and multiple MTS in lungs, liver, retroperitoneal space, left kidney, thrombosis of left adrenal vein and vena cava inferior. Liver biopsy was performed and revealed ACC MTS. Patient was approved for palliative chemotherapy. Third course of palliative chemotherapy has been cancelled due to the deterioration of the general condition.
Conclusion:
Case report presents long period of diagnosing ACC. Early identification of tumour is the key due to the rarity of tumour, where surgery is the main management of localized disease.
Adrenocortical carcinoma (ACC) is a rare malignancy with an incidence of 0.5-2 new cases per million people per year.
Method:
65-year-old female suffered from progressive pain in right knee in February 2022.
Results:
X-ray was done displaying 6cm cystic lesion in proximal tibia. Magnetic resonance (MRI) was performed after 2 months revealing right tibia malignant tumour, with highest probability –osteosarcoma. Afterwards general practitioner (GP) suggested chest and abdominal CT. Left side 10cm adrenal and 2cm kidney tumours and 2cm mass in between caecum and right psoas muscle were discovered. In July 2022 biopsy from right tibia tumour was done. Pathohistological examination revealed metastasis (MTS) of pheochromocytoma. In August 2022 patient was referred to university hospital for endocrine surgeon consultation and admitted urgently to department of endocrinology due to severe hypokalaemia and hypercortisolaemia. Treatment with fluconazole and spironolactone was started. Tumour markers CA 19-9, CEA, CA 15-3, CA 125 were negative. Control CT revealed 13cm left adrenal tumour and multiple MTS in lungs, liver, retroperitoneal space, left kidney, thrombosis of left adrenal vein and vena cava inferior. Liver biopsy was performed and revealed ACC MTS. Patient was approved for palliative chemotherapy. Third course of palliative chemotherapy has been cancelled due to the deterioration of the general condition.
Conclusion:
Case report presents long period of diagnosing ACC. Early identification of tumour is the key due to the rarity of tumour, where surgery is the main management of localized disease.
| Original language | English |
|---|---|
| Pages | 173-173 |
| Number of pages | 1 |
| Publication status | Published - 2023 |
| Externally published | Yes |
| Event | 10th Conference of European Society of Endocrine Surgeons: Consensus meeting on advanced endocrine malignancies - Mainz, Germany Duration: 18 May 2023 → 20 May 2023 Conference number: 10 https://eses2023.org/ |
Conference
| Conference | 10th Conference of European Society of Endocrine Surgeons |
|---|---|
| Country/Territory | Germany |
| City | Mainz |
| Period | 18/05/23 → 20/05/23 |
| Internet address |
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)