Adult Adrenocortical Carcinoma Mass with Extension into the Inferior Vena Cava and Cushingoid Features: a Rare Case with the Review of Literature

Abstract

Adrenocortical carcinomas (ACC) is an uncommon disease that accounts for only 0.02% of all cancers. Herein, this study evaluates a case of adult ACC with extension into the inferior vena cava and Cushingoid features. A 67-year-old lady was admitted to the surgery service for surgical resection of adrenal mass which was found on hypertension work-up. On physical examination, she was fat, cushingoid and had ecchymoses on her skin. The patient was hypokalemic at the time of admission. Spiral CT with contrast of the abdomen and pelvis was done and showed solid mass measuring 10x11 cm, upper to the right kidney and posterior to IVC (inferior vena cava) with anterior displacement of IVC. Microscopic diagnosis was adrenocortical carcinoma with vascular invasion and necrosis (20% of surface area) in this case. In conclusion, the hypertension can be the most common complaints in ACC patients and probably, the existence of both hypertension and hypokalemia in a case can increase suspicion of ACC that it needs to future studies with focus on these complaints.