![]() Biochemical evaluation should be performed to diagnose hormonally active tumors. ConclusionĪdrenal masses are highly prevalent and are detected at increasing rates with widespread use of cross-sectional imaging. The patient is currently undergoing adjuvant mitotane therapy and has no evidence of disease six months after surgery. Postoperatively, the symptoms of hypercortisolism, virilization, and hypertension resolved. Pathological exam demonstrated a 728 g, 16.5 cm ACC with extensive necrosis, and Ki67 proliferation index of 35% and large vessel vascular invasion. The tumor was able to be mobilized from surrounding structures without requiring resection of adjacent organs. The patient underwent open right adrenalectomy for the presumptive diagnosis of hormonally active adrenocortical carcinoma (ACC). Abdominal imaging demonstrated an 11 cm right adrenal mass, abutting the right hepatic lobe, right kidney, and inferior vena cava. Biochemical evaluation revealed hypercortisolism and elevated DHEA-S. SummaryĪ 24-year old previously healthy woman presented with a six-month history of weight gain, amenorrhea, hirsutism, acne, and hypertension. Adrenal tumors are common and frequently identified incidentally adrenalectomy is indicated for functional tumors, masses ≥4 cm, and cases where malignancy is suspected. ![]()
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