Adrenocortical carcinoma presenting as subclinical hypercortisolism in a young adult female: A case report

Mary Grace Astudillo. MD

Introduction: Adrenocortical carcinoma is a rare adrenal malignancy which may present with symptoms similar to Cushing’s syndrome and flank pain.

Presentation of Case: A 30-year old female presented with symptoms of hypercortisolism manifesting as hypertension, palpitations, headaches and sweating. Plasma Renin and aldosterone was done which revealed unsuppressed cortisol after dexamethasone suppression. A heterogenously enhancing right suprarenal mass was found on CT scan. Surgical excision was done and final histopathology revealed adrenocortical carcinoma with high proliferative index.

Discussion: Complete surgical resection is the mainstay management of adrenocortical carcinoma. In addition, hormonal evaluation is very important to prevent peri-operative complications.

Conclusion: Adrenocortical carcinoma should always be suspected in anyone presenting with an adrenal mass. Complete surgical excision and peri-operative hormonal management is important.