Key result
Large adrenal masses reveal diverse pathologies ranging from benign processes to high-grade carcinomas.
Why the study?
Adrenocortical carcinoma is a rare malignancy that is challenging to diagnose and must be considered in the differential diagnosis of large adrenal masses due to important surgical implications.
Case Report (n=5)
No
Large adrenal masses present with diverse pathology, including rare but aggressive adrenocortical carcinoma, necessitating vigilance during surgical evaluation.
Large adrenal masses may harbor malignancy; this case series leaves open optimal preoperative evaluation strategies.
Background: Adrenocortical carcinoma (ACC) is a rare malignancy that is challenging to diagnose and has important implications for surgeons who approach this disease. Despite its rarity, it must always be in the differential diagnosis when investigating and treating large adrenal masses. We aim to demonstrate the complexities of this disease through a review of five recent patients at a single tertiary care center. Methods: A series of five patients are described, each of whom presented to a single institution as referrals for "large adrenal mass" in the past sixteen months. Their pre-operative diagnosis, radiographic findings, the operative approach and the pathology results were examined. Results: The first patient had a 12 cm high grade adrenocortical carcinoma. The second patient had pathology consistent with a 9 cm, high grade ACC. The third had a liposarcoma. The fourth patient had a myelolipoma. The fifth was diagnosed with a benign process. Conclusion: Although adrenocortical carcinoma is an uncommon cancer, it has significant implications for the patient's prognosis and ultimately, their treatment algorithm. Therefore, when evaluating large adrenal masses, surgeons must remain vigilant of the possibility of adrenocortical carcinoma.
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Cooke‐Barber et al. (2020) conducted a case report in Large adrenal masses (n=5). Large adrenal mass was evaluated on Pathology results. Among 5 patients evaluated for large adrenal masses, final pathology revealed two high-grade adrenocortical carcinomas, one liposarcoma, one myelolipoma, and one benign process.
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