A Case Report of Bilateral Adrenocortical Carcinoma Complicated by Adrenal Insufficiency

Min Joo Kim; Jung Hee Kim; Tae Young Kim; Sang Wan Kim

doi:10.3803/EnM.2011.26.3.243

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Kim, Kim, Kim, and Kim: A Case Report of Bilateral Adrenocortical Carcinoma Complicated by Adrenal Insufficiency

Case Report

Endocrinol Metab 2011;26(3):243-247.

Published online: 5 September 2011

DOI: https://doi.org/10.3803/EnM.2011.26.3.243

A Case Report of Bilateral Adrenocortical Carcinoma Complicated by Adrenal Insufficiency

Min Joo Kim, Jung Hee Kim, Tae Young Kim¹, Sang Wan Kim²

Department of Internal Medicine, Seoul National University College of Medicine, Seoul

¹Division of Hematology and Oncology, Seoul, Korea

²Division of Endocrinology and Metabolism, Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea

Corresponding author: Sang Wan Kim Division of Endocrinology and Metabolism, Seoul Metropolitan Government Boramae Medical Center, 41 Boramae-gil 39, Dongjak-gu, Seoul 156-707, Korea Tel: +82-2-870-2223, Fax: +82-2-870-3863, E-mail: swkimmd@snu.ac.kr

Received 19 September 2010 Accepted 15 December 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Adrenocortical carcinoma is often functional and presents with signs and symptoms of adrenal steroid hormone excess. Adrenal insufficiency secondary to bilateral adrenocortical carcinoma is a particularly rare complication. We recently encountered a case of bilateral adrenocortical carcinoma complicated by adrenal insufficiency. A 52-year-old male was transferred to this hospital com-plaining of general weakness and weight loss. A bilateral adrenal mass was detected on abdomen CT. Plasma cortisol and aldoste-rone failed to rise during the rapid ACTH stimulation test. The CT-guided adrenal biopsy revealed findings consistent with adrenocortical carcinoma. Left hemiparesis was developed and brain metastasis was detected via brain MRI. Despite the application of gamma knife surgery and chemotherapy, the disease progressed and the patient died.

Keywords: Adrenal cortex neoplasm, Adrenal insufficiency, Adrenocortical carcinoma

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Fig. 1.

Computed tomography of abdomen showed 5.0 cm sized bilateral adrenal mass.

Fig. 2.

A. Biopsy of the adrenal mass showed poorly differentiated carcinoma (H&E stain, × 400). B. Immunohistochemistry showed positive results for vimentin staining (× 400).

Fig. 3.

Brain MRI (T2 weighted image) showed 1.7 cm sized mass with peripheral edema in right frontal lobe.

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