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December 17, 2025Journal of Case Reports and Images in OncologyOpen Access

The paradox of size: A case of indolent oncocytic adrenocortical carcinoma and review of literature

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Why the study?

Oncocytic adrenocortical carcinoma is a rare variant of adrenocortical carcinoma whose paradoxical indolent biological behavior makes diagnosis and management challenging.

Design

Case report and literature review

Key result

In a 45-year-old female with a 24 cm oncocytic adrenocortical carcinoma, multiorgan surgical resection followed by radiation resulted in no evidence of tumor recurrence at three months.

Authors

SOSujata OjhaOPOm PandeyBGBoone Goodgame

Discussion

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Overview

Favorable short-term outcome should not yet change practice; leaves open prognostic implications of oncocytic histology despite high-risk features.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 45-year-old female presenting with a large oncocytic adrenocortical carcinoma who underwent multiorgan surgical resection and external beam radiation therapy.
I
Intervention
Left adrenalectomy with en bloc pancreatectomy, splenectomy, left nephrectomy, and paraaortic lymphadenectomy, followed by external beam radiation therapy.

A large oncocytic adrenocortical carcinoma with necrosis and venous invasion can exhibit an indolent clinical course and favorable molecular profile, highlighting a clinical paradox where size does not always predict poor prognosis.

Limitations

  • Standardized treatment protocols are lacking due to the rarity of the disease
  • Comprehensive genomic studies are limited due to the rare nature of oncocytic adrenocortical carcinoma

Cite This Study

Ojha et al. (2025) conducted a case report in Oncocytic adrenocortical carcinoma (n=1). Surgical resection and external beam radiation therapy was evaluated on Tumor recurrence. In a 45-year-old female with a 24 cm oncocytic adrenocortical carcinoma, multiorgan surgical resection followed by radiation resulted in no evidence of tumor recurrence at three months.

synapsesocial.com/papers/6a802d71e1341be402e46291https://doi.org/10.5348/100151z10so2025cr
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