Adrenocortical Carcinoma in Pregnancy. The First Case Report in Mexico and Review of the Literature.

Figures

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  Fig. 1.. a A CT scan of the abdomen and pelvis revealed a left adrenal lesion. In the non-contrast phase with axial reconstruction, an ovoid, well-defined, and homogeneous mass was observed, isodense relative to the spleen, measuring approximately 50 mm in its greatest diameter. b Following intravenous contrast administration, during the venous phase, the lesion exhibited intense, heterogeneous nodular enhancement with central hypodense (poorly enhancing) areas. c, d In MRI, the mass displaced the ipsilateral kidney inferiorly and posteriorly, with no evidence of local invasion into adjacent structures. These findings are consistent with a tumoral lesion of the left adrenal gland, demonstrating radiologic features suggestive of malignancy. e, f Currently, a contrast-enhanced CT scan was performed 8 months after surgery with coronal and axial reconstructions, without evidence of tumor activity.

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  Fig. 2.. a Histopathological examination revealed an adrenal tumor measuring 4 × 3.5 × 3 cm, consistent with an adrenocortical carcinoma. The neoplasm was classified as high grade, showing more than 20 mitoses per 50 high-power fields. There was no evidence of lymphovascular invasion, and the tumor remained confined to the adrenal cortex, without capsular invasion. Surgical margins were negative for neoplastic involvement, confirming complete excision. Additionally, areas of intratumoral hemorrhage were identified (b–d).